摘要
Bone metastasis occurs as a result of a complex pathophysiologic process between host and tumor cells leading tO cellular invasion,migration adhesion,and stimulation of osteoclastic and osteoblastic activity.Several sequences occur as a result of osseous metastases and resulting bone pain Can lead to significant debilitation.Pain associated with osseous metastasis is thought to be distinct from neuropathic or inflammatory pain.Several mechanisms,such as invasion of tumor cells,spinal cord astrogliosis. and sensitization of nervous system,have been postulated to cause pain.Pharmaceutical therapy of bone pain includes nonsteroidal analgesics and opiates.These drugs are associated with side effects,and tolerance to these agents necessitates treatment with other modalities.Bisphosphonates act by inhibiting osteoclast—mediated resorption and have been increasingly used in treatment of pain- ful bone metastasis.While external beam radiation therapy remains the mainstay of pain palliation of solitary lesions,bone-seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions.32P has been used for over 3 decades in the treatment of multiple osseous metastases.The myelosuppression caused by this agent has led to the development of other bone-seeking radiopharmaceuticals.including 89SrCl.and 153Sm-ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP).89Sr is a bone-seeking radionuclide.whereas 153Sm—EDTMP is a bone—seeking tetraphosphonate;both have been approved by the Food and Drug Administration for the treatment of painful osseous metastases.While both agents have been shown to have efficacy in the treatment of painful osseous metastases from prostate cancer,they may also have utility in the treatment of painful OSSEOUS metastases from breast cancer and perhaps from non—small cell lung cancer.This article illustrates the salient features of these radiopharmaceuticals,including the approved dose,method of administration,and indications for use.
Bone metastasis occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequences occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. Pain associated with osseous metastasis is thought to be distinct from neuropathic or inflammatory pain. Several mechanisms, such as invasion of tumor cells, spinal cord astrogliosis, and sensitization of nervous system, have been postulated to cause pain. Pharmaceutical therapy of bone pain includes nonsteroidal analgesics and opiates. These drugs are associated with side effects, and tolerance to these agents necessitates treatment with other modalities. Bisphosphonates act by inhibiting osteoclast-mediated resorption and have been increasingly used in treatment of painful bone metastasis. While external beam radiation therapy remains the mainstay of pain palliation of solitary lesions, bone-seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. ^32p has been used for over 3 decades in the treatment of multiple osseous metastases. The myelosuppression caused by this agent has led to the development of other bone-seeking radiopharmaceuticals, including ^89SrCl, and ^153Sm-ethylenediaminetetramethylene phosphonic acid （^153Sm-EDTMP）. ^89Sr is a bone-seeking radionuclide, whereas ^153Sm-EDTMP is a bone-seeking tetraphosphonate; both have been approved by the Food and Drug Administration for the treatment of painful osseous metastases. While both agents have been shown to have efficacy in the treatment of painful osseous metastases from prostate cancer, they may also have utility in the treatment of painful osseous metastases from breast cancer and perhaps from non-small cell lung cancer. This article illustrates the salient features of these radiopharmaceuticals, including the approved dose, method of administration, and indications for use.
出处
《中国介入影像与治疗学》
CSCD
2006年第3期224-230,共7页
Chinese Journal of Interventional Imaging and Therapy
关键词
骨骼疾病
骨骼移植
治疗
临床
Radiopharmaceutical therapy
Bone-seeking radiopharmaceuticals
Bone pain
Osseous metastases
