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目的系统评价唑来膦酸和帕米膦酸二钠治疗实体瘤骨转移疼痛疗效的差异。方法通过PubMed和CNKI数据库检索所有符合检索条件的文献,末次检索日期2010年9月15日,根据纳入和排除标准进一步筛选。采用Meta分析方法比较唑来膦酸和帕米磷酸二钠用药后第7天或第14天治疗骨转移疼痛的疗效。两组用药方案:唑来膦酸组,4mg/次;帕米膦酸二钠组,60mg/次或90mg/次。疗效评价标准采用WHO癌痛分级及疗效评价标准。结果 29篇文献纳入Meta分析,唑来膦酸组和帕米膦酸二钠组病例数分别为1099例和1092例。唑来膦酸治疗骨转移疼痛总有效率显著高于帕米膦酸二钠,RR=0.93(95%CI:0.88～0.98),P=0.005,显效率也显著高于帕米膦酸二钠,RR=0.82(95%CI:0.69～0.97),P=0.02。结论唑来膦酸较帕米膦酸二钠治疗肿瘤骨转移疼痛疗效更好。
Objective To evaluate the efficacy of zoledronic acid and pamidronate in the treatment of solid tumors with bone metastases. Methods All the documents that meet the search criteria were searched through PubMed and CNKI databases. The date of the last search was September 15, 2010, and was further screened based on inclusion and exclusion criteria. Meta-analysis was used to compare the efficacy of zoledronic acid and disodium pamidronate in the treatment of bone metastases pain on day 7 or day 14. Two groups of drug regimens: zoledronic acid group, 4mg / time; pamidronate disodium group, 60mg / times or 90mg / times. Efficacy evaluation criteria using WHO classification of cancer pain and efficacy evaluation criteria. Results Twenty-nine articles were included in the Meta-analysis. The number of cases with zoledronic acid and pamidronate disodium were 1099 and 1092, respectively. The total effective rate of zoledronic acid in the treatment of bone metastasis was significantly higher than that of pamidronate (RR = 0.93 (95% CI: 0.88-0.98), P = 0.005). The effective rate was also significantly higher than that of pamidronate , RR = 0.82 (95% CI: 0.69-0.97), P = 0.02. Conclusion Zoledronic acid is more effective than pamidronate disodium in the treatment of bone metastases.