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转移性骨肿瘤骨痛^(89)SrCl_2治疗的疗效评价 被引量:11

An Evaluation of Strontium-89 Chloridefor Palliative Treatment of 449 Cases in Bony Metastases
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摘要 目的评价^(89)SrCl2对转移性骨肿瘤骨痛的缓解疗效。方法449例不同程度骨痛的多发性骨转移患者,其中原发灶明确394例(肺癌120例,前列腺癌109例,乳腺癌57例,肠癌24例,胃癌21例,鼻咽癌13例,肾癌10例,肝癌7例,食道癌6例,其它肿瘤27例),原发灶不明的55例。单次^(89)SrCl2治疗剂量为148MBq(4mCi),449例中单次治疗318例,2次治疗57例,3次治疗32例,4次治疗16例,5次治疗11例,6次治疗5例,7次治疗4例,8次和9次治疗各3例。治疗间隔3~11月。治疗后每月复查血常规和肝肾功能。结果经^(89)SrCl2治疗后2月~6年的随访,449例病人中,84例显效(84/449,18.7%),277例有效(277/449,61.7%),88例无效(88/449,19.6.9%)。单次治疗患者中的210例,治疗后3月复查骨显像,其中75例(75/210,35.7%)骨转移灶代谢减低、缩小或消失。治疗前后ROI比值比较,P<0.05。疼痛缓解开始于治疗后14天左右,疼痛缓解维持时间为3~9月。治疗后仅有少数患者见血白细胞和血小板计数有下降,但基本在正常范围内。结论本组449例肿瘤骨转移患者用^(89)SrCl2治疗后,骨痛缓解总有效率为80.4%,多数患者疼痛缓解,生活质量有所改善,且未见明显的相关血液学毒性反应。 Objective To evaluate the palliative treatment effect of strontium-89 chloride for bony metastases. Methods In 449 cases with bone pain of multiple and diffuse metastases, 394 cases were identified as primary cancer (120 lung carcinoma, 109 prostate carcinoma, 57 breast carcinoma, 24 intestinal carcinoma,21gastric carcinoma, 13 nasopharyngeal carcinoma, 10 renal carcinoma, 7 liver carcinoma,6 esophagus carcinoma and 27 other carcinoma), 55 cases were unknown primary cancer. The therapy dosage of strontium-89 chloride was 148MBq (4mCi) for every single injection. In 449 cases, 318 cases were injected with single injection, 57 cases with two times, 32 cases with three times, 16 cases with four times, llcases with five times, 5cases with six times, 4 cases with seventimes, and3 cases with eight times and ninth times of injections respectively. The repeated interval was 3-11 months. Serial blood counts were checked monthly post- injection. Results During the period of 2 months to 6 years follow-up in 449 patients, 84 cases presented dramatic decreased in bone pain (18.7%), 277 cases showed some relief of bone pain(61.7% ), and 88 cases had no improvement in bone pain ( 19. 6% ). The number and the size of metastatic cancer nests decreased or vanished in 210 cases(75/210,35.7% ). The ratios of counts of ROIs in the metastatic lesions, compared to counts of ROIs in normal counterparts after treatment, decreased significantly (P 〈 0.05 ). Pain relief usually began in 14 days and lasted up to 3 - 9 months. In few cases, white blood count and platelets were decreased after injection, but all were among the normal range. Conclusion In this group of 449 cases of painful bony metastases treated by strontium-89 chloride, the effectiveness of pain relief was 80.4%. Most of patients showed decreased bony pain, and the quality of life was improved. This palliative treatment showed no relevant hematological toxicity.
作者 陈刚 张淼 胡佳佳 管樑 CHEN Gang;ZHANG Miao;HU Jia-jia;GUAN Liang(Departmentof Nuclear Medicine,RuiJin Hospital,Medical School of Jiao Tong University,Shanghai 20002)
出处 《标记免疫分析与临床》 CAS 2018年第9期1301-1304,共4页 Labeled Immunoassays and Clinical Medicine
关键词 放射性核素治疗 ^89SRCL2 骨痛 转移 Radiotherapy Strontium-89 chloride Bone pain Metastases
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