^(153)Sm-EDTMP治疗肿瘤骨转移痛的临床观察

Clinical observation of ^(153)Sm-EDTMP in treatment of painful bone metastasis in cancer patients

目的观察153Sm-EDTMP(153钐标记乙二胺四甲撑膦酸)在治疗肿瘤骨转移疼痛中的止痛效果及其毒副反应。方法103例肿瘤骨转移疼痛患者,使用153Sm-EDTMP(37 MBq/kg)静脉注射单次治疗。记录治疗前后的疼痛评分[用直观类比标度(visual analog scale,VAS)判断]、体力评分,每周观察血常规变化以分析毒性作用,疗效判断以VAS评分下降≥2分为有效,0分为完全缓解。结果治疗后血细胞计数出现下降,但下降是短暂的、可逆的,治疗后8周已接近基线水平,除入组时已处于轻度毒性状态的患者出现级毒性反应外,其余患者均不超过级以上毒性。用药后6周疼痛评分下降到最低值,体力评分于用药后逐渐上升,4周时最高。总有效率为76%,完全缓解率为15%。结论153Sm-EDTMP是行之有效的骨转移骨痛缓解药物,起效快、维持时间长,可明显提高患者的生活质量。

Objective To evaluate the efficacy and adverse effects of 153Sm-EDTMP in pain palliation of bone metastases in cancer patients. Method One hundred and three cancer patients with painful bone metastasis were treated by 153Sm- EDTMP （37 MBq/kg）,and the pain -palliation effect,quality of life,and bone marrow function were studied. Visual analog scale （VAS） was conducted before and after treatment; and blood counts were performed weekly before and 4,6 and 8 weeks after treatment. Results Total 76% patients reported pain relief. VAS showed a maximal decrease at week 6 after treatment （P〈0. 05）. Improvement on Karnofsky performance scale was reported,most predominant at week 4 after treatment （P〈 0.05）. There was transient descent of blood cell counts,and returned to baseline levels at week 8 after treatment. Only patients who had myelosuppression before treatment might present grade Ⅱ toxicity. Conclusion 153Sm-EDTMP is effective in pain palliation without severe side effects ,and it may improve the quality of life of patients.