肺癌骨转移专家共识含解析.ppt

小结-4、规范化双膦酸盐治疗 BP SRE (N=55) 肿瘤骨转移患者 (N=3223) 至少有1次SRE患者 (N=745) 没有SRE患者 (N=2478) SRE BP (N=690) 骨转移 BP (N=839) 骨转移/BP同日 (N=1410) SRE 促使BP BP延迟使用 数据缺失(N=229) 本次调查发现，在已经发生SRE的这部分患者中， 93%的患者都是由于发生了SRE才促使使用双膦酸盐治疗。在没有发生SRE的这部分患者中，37%的患者在骨转移确诊后延迟使用了双膦酸盐（平均延迟3个月以上）． 在《专家共识》以后的推广中，应着重强调骨转移确诊后立即使用双膦酸盐，不要陷入出现SRE或者骨痛等症状才进行双膦酸盐治疗的误区。 * 小结-5、双膦酸盐有效延缓SRE 根据《专家共识》介绍，随着双膦酸盐用药时间的延长，能够有效减少SRE事件的发生，以及延缓SRE的发生时间。 本次调查同样验证了这一点，随着双膦酸盐治疗时间的延长，患者SRE的发生时间也越长． SRE发生时间（月） N=533 N=36 N=18 N=5 0-5 月 5-10 月 10-15 月 ＞ 15 月 3.4 5.3 7.0 21.1 0 10 20 30 小结-6、双膦酸盐药物的选择 本次调研发现，相对于其他双膦酸来说，目前临床上绝大多数患者都会选择使用必威体育精装版的第三代双膦酸盐药物。 肿瘤骨转移病人 (N=3223) 双膦酸盐治疗 (N=3223) 其他药物治疗 (N=0) 氯屈膦酸 (N=11) 帕米膦酸 (N=629) 唑来膦酸/伊班膦酸 (N=2583) * A large, multicenter, retrospective epidemiological survey the incidence and treatment of bone metastatic disease in Chinese cancer patients BACKGROUND Bone metastases (BM) are common in patients with advanced cancer. Bisphosphonates (BPs) had been used for those patients to prevent or delay the development of skeletal related events (SRE). The objective of this survey was to identify clinical features and treatment strategies in Chinese cancer patients with BM as well as SREs. METHODS This survey included consecutive patients with solid tumor and diagnosed with BM enrolled in 5 months on average, and who were treated with BPs from January 2008. Data included demographics, tumor type, sites of BM, incidence and proportion of SRE in different tumor type, type and duration of BPs treatments, the association between BPs use and change in the subsequent rates of SRE; the relation between BPs treatment persistency and the rate of SRE. RESULTS Totally, 3,223 cancer patients were included from 53 hospitals located 30 provinces throughout china. The common tumor types were lung (37%), breast (31%), prostate (9%) and GI tumor (5%). The sites of BM included thoracic spine (56%), lumber spine (47%), ribs (33%), Ilium+sacrum (23%), femur (18%). The incidence of SRE was 23.1% a