肺癌骨转移病例讨论（规范用药）.pptVIP

* * Zoledronic Acid Reduced the Risk of Developing an SRE Treatment with 4 mg zoledronic acid significantly reduced the risk of developing an SRE by 31% compared with placebo (hazard ratio = 0.693; 95% confidence interval [CI] = 0.542, 0.886; P = .003) Multiple event analysis provides a sensitive measure of skeletal morbidity because it accounts for all events as well as the time between events The hazard ratio reflects the risk of experiencing an SRE between 2 treatment groups; a hazard ratio of 1 indicates a decreased risk for patients treated with 4 mg zoledronic acid. If the upper boundary of the 95% CI is 1, the reduction in risk is statistically significant (P .05) To ensure the independence of skeletal events analyzed, a 21-day event window was used to count SREs, such that any event that occurred within 21 days of a previous event was not counted as a separate event. This prevented linked events, such as surgery to repair a fracture, from being counted as separate events and thus inflating the incidence of events REFERENCES Rosen LS, Gordon D, Tchekmedyian NS, et al. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with non-small cell lung carcinoma and other solid tumors: a randomized, phase III, double-blind, placebo-controlled trial. Cancer. 2004;100:2613-2621. * * * * 1 * 1 Benefit of BP therapy with ZOL and IBA in breast cancer has been shown for a treatment duration of up to 2 years. Since the risk of SREs is going to continue, the expert panel-in the absence of supporting data-recommends continuation of therapy beyond 2 years but always based on an individual risk assessment. 乳腺癌患者接受唑来和伊班膦酸治疗的两年内都可获益。 由于SRE的风险在两年后仍继续存在，尽管缺乏数据，但仍继续使用双膦酸盐。 M.Aapro，et al，Annals of Oncology 19: 420–432, 2008 * * * * 病例讨论- 肺癌骨转移伴疼痛的初始治疗和长期应用 M002241102 骨转移伴疼痛的初始治疗和长期应用 56岁,男性，体力状态良好 2006年1月主诉左侧大腿疼痛 X线平片确认左股骨占位病灶 MRI确认左股骨占位病灶，发现周围软组织受浸润 怀疑肿瘤骨转移病灶 骨转移伴疼痛的初始治疗和长期应用 患者诊断为晚期肺癌骨转移，您目前推荐的治疗方案？ 姑息性化疗 化疗+姑息止痛治疗(不包括