核素^(89)Sr治疗前列腺癌骨转移临床价值及血清tPSA变化的研究

Clinical Effect and Change of Serum fPSA Levels After Nucleotide ^(89)Sr Therapy in Patients with Multiple Foci Bone Metastasis From Prostatic Cancer

目的:探讨89锶(89Sr)治疗前列腺癌多发骨转移的效果。方法:经病理证实31例前列腺癌多发骨转移的患者共行50次89Sr内照射治疗。治疗后随访患者的血常规、肝功能、肾功能、tPSA、骨痛评分及99mTc-MDP全身骨显像。根据骨痛的缓解情况分为4级:Ⅰ级(无反应),Ⅱ级(有反应),Ⅲ级(缓解),Ⅳ级(完全缓解)。结果:31例患者中,总有效率为74.2%。其中Ⅳ级5例,Ⅲ级18例,Ⅱ级6例,Ⅰ级2例。副作用轻微、一过性的骨髓抑制,89Sr治疗后,患者的PSA下降。结论:89Sr有非常高的骨痛缓解率和非常小的副作用,前列腺癌多发骨转移应采取89Sr治疗。

Objective To investigate the clinical effect of ^89Sr therapy in patients with bone metastasis from prostatic cancer. Methods Thirty one patients with multiple foci （over 3） bone metastasis from prostatic cancer were treated with intravenous ^89SrCl2 （40 -50μCi/kg） as a single dose （21 patients） or with a second dose given 3 -6 months apart. Serum fPSA levds and ^99mTc -MDP whole body scan were performed both before and after the treatment. Results Treatment result was considered to be significantly improved （ significantly decreased requirement of analgesics/narcotics） in 18 patients and with remission （ no need of analgesics） in 5 patients. Serum fPSA levels measured in 22 patients 1 - 3 months after treatment were significantly lower than those before treatment and bone scan in 15 patients studied 3 - 6 months after treatment revealed regression of the lesions. Conclusion ^89 Sr treatment for bone metastasis was quite satisfactory with high improvement rate in pain control and very few side effects of mild transient bone marrow depression only.