Abstract
Objective: To investigate the effect of zoledronic acid on the remission of bone pain in patients with non-small cell lung cancer (NSCLC) during and after radiotherapy. Materials and Methods: A total of 197 NSCLC patients who received radiotherapy for osteopathy with complete recorded visual analog scale (VAS) scores were enrolled. Of these, 79 patients were treated with radiotherapy alone (radiotherapy group), and 118 patients were treated with radiotherapy combined with zoledronic acid (zoledronic acid group). The differences in VAS scores between the two groups were compared. Logistic regression was used to determine the odds ratio (OR) of the complete response rate for osteodynia between the zoledronic acid group and the radiotherapy group. Univariate and multivariate Cox regression analyses were used to evaluate the independent prognostic factors for overall survival (OS). Results: The complete response rate in patients in the zoledronic acid group was significantly higher than that in patients in the radiotherapy group (odds ratio [OR] = 3.201, 95% confidence interval [CI]: 1.559-6.575, P = 0.002). Except for the baseline VAS score, all VAS scores in the zoledronic acid group at different time points during radiotherapy, at the end of radiotherapy, and 1 month after radiotherapy were significantly lower than those in the radiotherapy group (all P < 0.01). Grade 3 constipation was observed in only one patient in the zoledronic acid group. There were no other Grade 3 adverse events. Multivariate Cox regression analysis showed that only the treatment group (zoledronic acid group vs. radiotherapy group, hazard ratio [HR] = 0.720, 95% CI: 0.530-0.978, P = 0.036) and manner of bone destruction (mixture vs. osteolytic, HR = 0.596, 95% CI: 0.424-0.837, P = 0.003) were independent prognostic factors for OS. Conclusion: Zoledronic acid combined with radiotherapy can not only accelerate bone pain control but also prolong survival in NSCLC patients with bone metastases.
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