Zoledronic acid combined with chemotherapy in non-small cell lung cancer with bone metastasis

We aimed to investigate the efficacy and safety of zoledronic acid combined with chemotherapy in treating non-small cell lung cancer (NSCLC) with bone metastasis.

The clinical data of 148 NSCLC patients with bone metastasis were retrospectively analyzed. Among the patients, 74 were treated with zoledronic acid combined with chemotherapy (Zoledronic Acid group), while the remaining 74 received chemotherapy alone (Control group). The efficacy on bone metastasis, remission of bone pain, levels of bone metabolic markers before and after treatment, quality of life and incidence rate of adverse reactions were compared between the two groups. Besides, the patients were followed up, and their survival status was recorded.

The efficacy was evaluated in all patients at 1 month after treatment. It was found that the overall response rate of bone metastasis was significantly higher in the Zoledronic Acid group than that in the Control group. After treatment, the ostealgia remission rate was markedly higher in the Zoledronic Acid group than that in the Control group. After treatment, the serum levels of alkaline phosphatase (AKP), Ca2+, N-terminal telopeptide (NTx) and bone sialoprotein (BSP) declined notably in both groups in contrast with those before treatment, and they were prominently lower in the Zoledronic Acid group than those in the Control group after treatment. Moreover, after treatment, the Karnofski performance status (KPS) score was improved in both groups, and the Zoledronic Acid group had an evidently higher score than the Control group. The results of follow-up manifested that the 1-, 2- and 3-year overall survival (OS) rates in the Zoledronic Acid group and the Control group were 58.1% (43/74) vs. 43.2% (32/74), 40.5% (30/74) vs. 29.7% (22/74), and 24.3% (18/74) vs. 13.5% (10/74), respectively. Log-rank test revealed that the OS in the Zoledronic Acid group was significantly better than that in the Control group.

Zoledronic acid combined with chemotherapy is effective in the treatment of NSCLC with bone metastasis, which can markedly relieve bone pain, ameliorate the quality of life of patients, improve the long-term survival rate and reduce the incidence of SREs.