^(89)SrCl2治疗肺癌骨转移126例疗效分析

Therapeutic effects of strontium-89 against osseous metastases of lung cancer: analysis of 126 cases

目的探讨^(89)SrCl2治疗肺癌骨转移的疗效。方法不同病理类型肺癌骨转移患者126例,按148 MBq/人次确定给药剂量,^(89)SrCl2由肘静脉一次性注射。以疼痛程度、疼痛频率及疼痛得分的变化衡量止痛效果,以病灶数目或大小的变化判断病灶疗效,比较不同病理类型肺癌疗效差异。结果治疗后6个月内,疼痛减轻率为70.6%(89/126),其中消失率为19.8%(25/126),表明疼痛程度明显缓解(u=5.361,P<0.01);78.6%(99/126)的患者疼痛频率下降,疼痛次数明显减少(u=4.589,P<0.01),其中25例疼痛不再发作。疼痛评分由7.54±3.29降低至4.19±4.38,降低显著(t=6.865,P<0.001)。病灶数目或大小减少25%以上者占45.2%(57/126)。^(89)SrCl2对鳞癌疼痛程度、频率缓解分别为85.7%(30/35)和88.6%(31/35),病灶改善率为57.1%(20/35)。各指标在4种肿瘤类型之间均无显著性差异(P>0.05)。结论^(89)SrCl2对肺癌骨转移的疗效较好,可缓解疼痛,改善病灶;^(89)SrCl2对不同病理类型肺癌骨转移疗效无明显差异。

Objective To investigate the therapeutic effects of strontium-89 against osseous metastases of lung cancer. Methods A total of 126 patients with osseous metastases of lung cancer received strontium-89 treatment (89SrCl2) at the dose of 148 MBq given through a single intravenous injection. The analgesic effect was evaluated by the changes in the degree, frequency and scores of the pain, and the therapeutic effect assessed by observing the changes in the number and volume of osseous lesions after therapy and compared between different pathological types of lung cancer by Ka-square test. Results Within 6 months after the injection, the total pain relief rate was 70.6% (89/126), including 25 (19.8%) cases with pain vanished, suggesting significant alleviation of the pain intensity by the treatment (u=5.361, P<0.01). The frequency of pain was reduced in 78.6% (99/126) of the cases (u=4.589, P<0.01), and the average score of pain decreased significantly from 7.54±3.29 to 4.19±4.38 (t=6.865, P<0.001). The number and size of lesions decreased by more than 25% in 57 cases, showing a total efficacy rate of 45.2% (57/126). No significant difference was noted in the therapeutic effects among the 4 pathological types of lung cancer (P>0.05). Conclusions Strontium-89 is effective for pain relief and tumor focus confinement in osseous metastases of lung cancer. No significant difference has been found in its effect between 4 different pathological types of lung cancer.