Treatment And Analysis Of Non-small-cell Lung Cancer With Bone Metastasis

[Objective]1. To study the Clinical Factors and Prognosis of non-small-cell lung cancer withbone metastasis;2. To compare zoledronic acid plus radiotherapy with zoledronic acid plus chemotherapy inthe treatment of non-small-cell lung cancer with bone metastasis;[Methods]1．149patients,with non-small-cell lung cancer with bone metastasis, were diagnosedby pathology and bone scan or CT or MRI or PET/CT in Beijing military area generalhospital from January2009to January2012. Follow-up all of the Patients andanalysis the factors of prognosis of non-small-cell lung cancer with bone metastasis,respectively form ages, sex, types of imaging, histologic type, Staging, with surgeryof primary site, with chemotherapy of primary site, with radiotherapy of primary site,patients numbers of metastases, others distant metastases and performance status(ECOG). Find out the factors of affecting the prognosis of non-small-cell lung cancerwith bone metastasis.2．Retrospectively,71patients with non-small-cell lung cancer with bone metastasis,Two groups were stratified for the different treatment,38patiens with radiotherapyand zoledronic acid,33patiens with chemotherapy and zoledronic acid. Observe thetwo groups rate of pain relief and the different quality of life and treatment effect ofbone metastasis and adverse reactions.[Results]1.149patients of non-small-cell lung cancer with bone metastasis the predominanthistology was adenocarcinoma (67.11%). The predominant metastatic site wasspine(44.80%). The prime metastatic site of lung adenocarcinomas was spine,chest and pelvis. The prime metastatic site of lung squamous-cell carcinoma was spine. The patients were multiple metastases of cancer to bones in71.81%, thesolitary in28.19%. The patients of non-small-cell lung cancer median survivalwas20months. The patients of non-small-cell lung cancer to identify bonemetastasis median survival was13months. The cumulative probability of survivalof149patients of non-small-cell lung cancer with bone metastasis on six months,one year and two years respectively was75.7%，50.2%，23.1%.In the univariateanalysis the factors of affecting the prognosis of non-small-cell lung cancer toidentify bone metastasis was performance status (ECOG), patients numbers ofmetastases and distant metastases (all P<0.05). In the multivariate analysis thefactors of affecting the prognosis of non-small-cell lung cancer to identify bonemetastasis was patients numbers of metastases, distant metastases，performancestatus (ECOG) and with chemotherapy of primary site (all P<0.05).2. The rate of pain relief between the group of radiotherapy combination zoledronicacid with the group of chemotherapy combination zoledronic acid, respectively92.10%vs69.69%，(P<0.05）,was statistically significant. The group ofradiotherapy combination zoledronic acid superior the group of chemotherapycombination zoledronic acid in the improve quality of life, especially in appetite,mental status and fatigue relieve (P<0.05）was statistically significant. Comparetwo groups’ rate of local control of bone metastasis (P>0.05）,was not statisticallysignificant. There are no serious adverse events happen.[Conelusion]1. In the patients of non-small-cell lung cancer with bone metastasis the predominanthistology was adenocarcinoma. The predominant metastatic site was spine. Themultiple metastases is more common.2. In the univariate analysis the factors of affecting the prognosis of non-small-celllung cancer to identify bone metastasis was performance status (ECOG), patientsnumbers of metastases and distant metastases.3. In the multivariate analysis the factors of affecting the prognosis of non-small-celllung cancer to identify bone metastasis was performance status (ECOG), patients numbers of metastases, distant metastases and with chemotherapy of primary site.4. By radiotherapy combination zoledronic acid, the patients’ rate of pain relief can besignificantly improved. Chemotherapy combination zoledronic acid is normallybeneficial for control bone metastasis. For the patients of fewer numbers ofmetastases and severe pain preferential use of local radiation therapy combinationzoledronic.