Therapeutic Effect Of Zoledronic Acid Combined With Radiotherapy On Bone Metastasis Of Lung Cancer And Changes Of Bone Metabolic Markers

Objective:To investigate the effect of zoledronic acid combined with radiotherapy on bone metastasis of lung cancer and the changes of bone metabolic markers.Backgrand:Lung cancer is one of the most common malignant tumors,which poses a great threat to human life and health.Bone,brain,liver and adrenal gland are common distant metastases of advanced lung cancer.Bone metastasis(BM)is a common complication of advanced lung cancer,and its treatment usually requires a variety of methods[2].Although great progress has been made in the treatment of bone metastasis in recent years,patients with bone metastasis may still experience bone-related events and symptomatic bone events,which may have a negative impact on their quality of life and survival.Methods:Retrospectively,188 patients with lung cancer with bone metastasis,including 143 patients with non-small cell lung cancer and 45 patients with small cell lung cancer.Non-small cell lung cancer patients and small cell lung cancer patients were divided into observation group and control group according to different treatment methods.The control group was treated with zoledronic acid,while the observation group was treated with zoledronic acid combined with radiotherapy.The differences of NRS score,pain control efficiency,bone metastasis control rate,side effects of zoledronic acid,serum ALP level and curative effect between the control group and the observation group were compared.Results:Patients with non-small cell lung cancer and small cell lung cancer were divided into observation group and control group according to different treatment methods.There was no significant difference in general clinical data between the two groups(P>0.05).The NRS scores of non-small cell lung cancer(NSCLC)and small cell lung cancer(NSCLC)patients with bone metastasis showed a decreasing trend,and the NRS score of 3 weeks after treatment was significantly lower than that of pre-treatment(P<0.05),the difference was statistically significant(P<0.05).Compared with the control group,the number of patients with complete and partial remission of bone metastases in the observation group was significantly increased,and the treatment efficiency was higher,the difference was significant.Moreover,the disease progression rate of bone metastases in the observation group was lower than that in the control group,and the local progress rate was lower.In patients with bone metastases from non-small cell lung cancer and small cell lung cancer,the correlation between NRS score and the efficacy of bone metastases was analyzed.The correlation coefficients r were 0.183 and 0.414 respectively,and P values were 0.028 and 0.005,respectively.There was a significant positive correlation between NRS score and the efficacy of bone metastases.Serum ALP levels in patients with non-small cell lung cancer(NSCLC)and bone metastasis from small cell lung cancer(NSCLC)were higher than normal levels before treatment.The mean value of ALP in patients with bone metastasis of?3 was significantly higher than that of patients with bone metastasis of>3(P = 0.046,0.036,P<0.05).After the treatment of anti-bone metastasis,the serum ALP level of non-small cell lung cancer(NSCLC)and small cell lung cancer(SCLC)group and control group were decreased,especially in the observation group(P<0.05).During the medication period,there were no serious adverse reactions in the observation group and the control group,including non-small cell and small cell lung cancer patients.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:1.Compared with zoledronic acid alone,zoledronic acid combined with radiotherapy for bone metastasis of non-small cell lung cancer and small cell lung cancer is more effective and effective.It can alleviate bone pain more obviously,control bone metastasis better and maintain for a longer time without increasing adverse reactions and has good safety.2.In patients with non-small cell lung cancer and small cell lung cancer,the change of NRS score after anti-bone metastasis treatment was positively correlated with the curative effect of bone metastasis.3.Serum ALP levels in patients with bone metastasis from non-small cell lung cancer and small cell lung cancer were higher than normal levels,suggesting that serum ALP levels can predict the occurrence of bone metastasis and have a positive correlation with bone metastasis load.When zoledronic acid combined with or without radiotherapy,the level of serum ALP decreased,which indicated that the change of serum ALP index could predict the condition of patients with bone metastasis of lung cancer,and had reference value for the evaluation of curative effect of anti-bone metastasis therapy.