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1、安徽医科大学硕士学位论文2．放疗联合唑来膦酸组治疗非小细胞肺癌骨转移的疼痛缓解率明显高于化疗联合唑来磷酸组（分别为92.10%vs69%，P<0.05）差异有统计学意义；放疗联合唑来膦酸组在生活质量的改善方面要优于化疗联合唑来膦酸组，尤其在食欲、精神、疲乏状态缓解程度上（均P<0.05），差异具有统计学意义；两组的骨转移灶的局部控制率比较（P>0.05），差异无统计学意义；两组均无严重的不良反应发生。[结论]1.非小细胞肺癌骨转移中腺癌的发生率最高，转移部位以脊柱为主，多发较常见；2.影响非小细胞肺癌骨转移患者生存的独立因素包括：患者
2、的一般生存状态(ECOG评分)、原发灶是否手术、骨转移灶的数目、是否伴有远处转移。3.影响非小细胞肺癌骨转移患者生存的多因素包括：一般生存状态(ECOG评分)、骨转移灶的数目、是否伴其他脏器转移、原发灶是否行全身化疗。4.放疗联合唑来膦酸可以明显的缓解骨痛，生活质量得以改善，化疗联合唑来膦酸可以更好的控制骨转移灶，对于骨转移灶数目较少、疼痛较剧烈者应优先选择局部放疗联合唑来膦酸的治疗。关键词非小细胞肺癌骨转移癌治疗预后4安徽医科大学硕士学位论文TreatmentandAnalysisofnon-small-celllungcancer
3、withbonemetastasisAbstract[Objective]1.TostudytheClinicalFactorsandPrognosisofnon-small-celllungcancerwithbonemetastasis;2.Tocomparezoledronicacidplusradiotherapywithzoledronicacidpluschemotherapyinthetreatmentofnon-small-celllungcancerwithbonemetastasis;[Methods]1．149p
4、atients,withnon-small-celllungcancerwithbonemetastasis,werediagnosedbypathologyandbonescanorCTorMRIorPET/CTinBeijingmilitaryareageneralhospitalfromJanuary2009toJanuary2012.Follow-upallofthePatientsandanalysisthefactorsofprognosisofnon-small-celllungcancerwithbonemetasta
5、sis,respectivelyformages,sex,typesofimaging,histologictype,Staging,withsurgeryofprimarysite,withchemotherapyofprimarysite,withradiotherapyofprimarysite,patientsnumbersofmetastases,othersdistantmetastasesandperformancestatus(ECOG).Findoutthefactorsofaffectingtheprognosis
6、ofnon-small-celllungcancerwithbonemetastasis.2．Retrospectively,71patientswithnon-small-celllungcancerwithbonemetastasis,Twogroupswerestratifiedforthedifferenttreatment,38patienswithradiotherapyandzoledronicacid,33patienswithchemotherapyandzoledronicacid.Observethetwogro
7、upsrateofpainreliefandthedifferentqualityoflifeandtreatmenteffectofbonemetastasisandadversereactions.[Results]1.149patientsofnon-small-celllungcancerwithbonemetastasisthepredominanthistologywasadenocarcinoma(67.11%).Thepredominantmetastaticsitewasspine(44.80%).Theprimem
8、etastaticsiteoflungadenocarcinomaswasspine,chestandpelvis.Theprimemetastaticsiteoflungsquamous-cellcarcinomawa
