多发骨转移癌联合治疗近期疗效观察

Short-term efficacy of combined treatment for multiple bone metastatic cancers

目的探讨缓解多发骨转移癌疼痛的有效治疗方法。方法190例多发骨转移癌患者,采用153Sm-EDTMP及153Sm-EDTMP加99Tc-MPD方案,观察治疗后1年疼痛缓解情况、病灶修复作用及安全性。结果总的镇痛缓解率为79.5%,病灶修复率31.1%;A、B两组镇痛缓解率及骨病变修复率分别为56.7%、86.9%和20.0%、35.5%,两组比较差异有显著性(P<0.05)。治疗骨转移的同时其他脏器的转移占13.6%。毒副反应以骨髓抑制为主,全组未见肝肾功能损害。结论采用以放射性核素为主的综合治疗方案,不仅能有效缓解骨疼痛,同时对病灶的修复有一定的治疗价值。建议在治疗骨转移的同时,只要血像正常,身体状况尚好,可以考虑配合其他治疗,以防止其他脏器的转移。

Objective To explore the effective treatment for relieving pain of bone metastases. Methods A total of 190 cases of multiple bone metastatic cancers treated in our department since 1999 were randomized into two groups. Group A ：the monotherapy group （^153 Sm-EDTMP）. Group B：the combined therapy group（ ^153Sm-EDTMP plus ^99mTc-MDP）. Efficacy in relieving pain and repairing focus and safety were evaluated after a year. Results The response rate of relieving pain and the rate of repairing focus were 79.5% （ 151/ 190） and 31.1% （33/106） respectively,including 56.7% and 20.0% in Group A,and 86.9% and 35.5% in Group B respectively. The response rate was significantly higher in Group B than in Group A （P 〈 0.05 ）. Bone marrow suppression was observed in both groups, but no hepatic or renal dysfunction was abserved. Conclu- sion Combined treatment with systemic radionuclides is a feasible and effective treatment for multiple bone metastatic cancers. Apart from relieving bone metastases pain, it is also valuable for repairing focus. The method of combination of ^153Sm-EDTMP with ^99mTc-MDP is suggested for current treatment.