Clinical Research Of Zoledronic Acid Concurrent With Radiotherapy In The Treatment Of Non-small Cell Lung Cancer Bone Metastasis

Objective:1.To Contrast the curative effect of radiotherapy alone and Zoledronic acid combine radiotherapy(combination therapy)in the treatment of NSCLC with bone metastases and to analysis the influence factors of two groups of patients with pain relief.In order to give possible clinical basis for patients with NSCLC Bone metastasis and choosing the treatment method for pain relief.2.To giving statistics,Survival analysis and setting up a COX’s proportional hazards model in order to find prognostic indicators for these patients.Methods:1.Looking over all kinds of clinical data in Chongqing Daping Hospital Radiotherapy Oncology Center,we find that there are 117 patients with 153 sites who were received radiotherapy alone and combination treatment from Jan.2009 to Dec.2013.Then establish a baseline data.2.To Contrast the curative effect of radiotherapy alone and combination therapy in the treatment of NSCLC with bone metastases and to giving multiple-factor analysis for all possible influence factors of two groups’ patients with pain relief.3.To Analyze Patients’ overall survival after bone metastasis and to giving Survival analysis for two groups of patients respectively.4.To use the COX proportional hazards model analysis Influence factors of NSCLC bone metastases patients’ OS after bone metastasis.Results:1.The pain remission rate of the radiotherapy alone and combination therapy are 69.7% and 92.2% respectively(χ2=12.572 P=0.000).2.After multivariate Logestic regression analysis,the pain relief of NSCLC patients with bone metastases is associated with the treatment style,and the curative effect of combination therapy group may be better.(OR=0.195,P=0.002 95% CI: 0.068~0.555)3.After Kaplan-Meier survival analysis,we found that NSCLC bone metastases Patients’ OS after bone metastasis was associated with whether SREs come up or not again after radiotherapy(P=0.040)and whether the bone pain relief were achieve Complete remission or not after radiotherapy(P=0.001).There is no difference of statistic between the treatment of zoledronic acid combined with radiotherapy and radiotherapy alone in NSCLC bone metastases patients’ OS after bone metastasis(p=0.163).4.We also found that the patients’ pain relief was achieve complete remission after radiotherapy and the SREs don’t come up again after radiotherapy were two independent prognostic factor in NSCLC bone metastases patients’ OS after bone metastasis.and the Equation :Y =-0.872 ×SREs situation after radiotherapy-0.702 × radiotherapy remission after radiotherapy.Conclusions:1.The treatment of zoledronic acid combined with radiotherapy and radiotherapy alone can be achieve pain relief in patients with bone metastases in NSCLC,The combination group’s Short-term efficacy of may be better.Zoledronic acid combined with radiotherapy might be a better treatment for pain relief in NSCLC patients with bone metastases.2.In non-small cell lung cancer patients with bone metastases Osteoblastic sites and Osteolytic sites can be brought benefits from combination group.and the Osteolytic sites may have the same or better effect。In the combined treatment subgroups,patients with osteoblastic metastases have better pain relief than that of osteolytic metastases(OR=10.090,P=0.048 95% CI: 1.018~100.010).3.Patients’ pain relief was achieve complete remission after radiotherapy and the SREs don’t come up again after radiotherapy were two independent prognostic factor in NSCLC bone metastases patients’ OS after bone metastasis.4.There is no difference between the Zoledronic acid combined with radiotherapy and radiotherapy alone in NSCLC bone metastases Patients’ OS after bone metastases.