^(99)Tc^m-MDP骨显像在肺癌骨转移疗效观察中的应用

The significance of ^(99)Tc^m-MDP bone imaging in therapeutic effect observation of bone metastasis in lung cancer patients

目的:应用99Tcm-MDP骨显像对肺癌骨转移患者的治疗效果进行分析,观察其疗效差异。方法:对178例肺癌患者,在系统治疗前均行99Tcm-亚甲基二膦酸盐(99Tcm-MDP)全身骨显像;85例骨显像阳性患者,单纯放疗40例,综合治疗(放疗同期化疗)45例,在治疗后2月复查骨显像,用统计学方法分析显像结果,对肺癌骨转移的治疗效果进行评价。结果:①单纯放疗组完全缓解(CR)5例,部分缓解(PR)12例,有效率(CR+PR)为42.5%;综合治疗组分别为7例,17例,53.3%。两组比较有效率无显著性差异(P>0.05)。②综合治疗组中腺癌骨转移病灶有效率45%(9/20);小细胞癌为80%(12/15);鳞癌则为30%(3/10)。三种病理类型肺癌骨转移灶综合治疗的有效率差异有显著性(P<0.05)。其中小细胞癌较腺癌、鳞癌骨转移灶疗效好(P均<0.05)。③接受综合治疗的患者骨显像共有近期疗效可评价者258个病灶,其中胸部、脊椎、骨盆、四肢和颅骨分别为145个(56.20%),57个(22.09%),34个(13.18%),22个(8.53%)。复查骨显像有效率分别为65.52%(95/145)、63.16%(36/57)、58.82%(20/34)、54.55%(12/22),无显著性差异(P>0.05)。结论:单纯放疗和放化疗联合均可有效治疗骨转移。不同病理类型患者应用综合治疗后效果有差异,而不同部位之间疗效无差异。应用99Tcm-MDP骨显像可对肺癌骨转移疗效进行较好观察。

Objective： To analyze and observe the difference of the therapeutic effect of bone metastasis in lung cancer patients with 99Tcm-MDP radionuclide whole-body hone imaging. Methods：One hundred and seventy eight patients, 99Tcm-MDP radionuclide bone imaging was performed before systemic treatments, and 85 patients with bone metastasis, 40 cases accepted radio therapy. 45 cases accepted synthetical treatments （radiotherapy synchronous chemotherapy）. Bone imaging was rechecked after therapy two months and the correlation between two therapies was analyzed with statistical methods. Results： （1）Simple radiotherapy group： CR 5, PR 12, effective rate （CR4-pR） 42.5%; synthetical treatments group： 7, 17, 53.3% respectively. No significant difference was showed between the effective rates of the two groups （ P 2〉0.05）. （2）Synthetical treatments group： the effective rate of adenocarcinoma abnormal bone focus was 45% （9/20）; small cell carcinoma 80% （12/15）; squamous carcinoma 30% （3/10）. The significant difference was showed among the effective rates of the three pathotypes （ P〈0.05）. The therapeutic effect for abnormal bone focus of small cell carcinoma was much better than that of the other two （ P 〈70.05）. （3） The patients of synthetical treatments group have 258 bone focuses which can be evaluated recent period. Chest, spine, pelvis and four limbs and skull involvements were 145 （56.20%）, 57 （22.09%）, 34 （13.18%） and 22 （8.53%）, and the effective rates were 65.52% （95/145）, 63. 16% （36/57）, 58. 82% （20/34） and 54.55% （12//22）, no significant difference was showed （ P〈0.05）. Conclusion： Both simple radiotherapy and radiochemotherapy can treat hone metastasis effectively. The significant difference of therapeutic effect after synthetical treatments is showed among the different pathotypes and no significant difference is showed among the different focal locations. 99Tcm-MDP radionuclide hone imaging has great value in monitoring therapeutic effect of bone metastasis in lung cancer patients.