骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值

Application of bone scintigraphy in therapy response monitoring and prognosis prediction in patients with bone metastasis from lung cancer and prostate cancer

目的探讨全身骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值。方法将40例肺癌患者和31例前列腺癌患者在系统治疗前1个月内及治疗≥3个月后分别行全身骨扫描,观察治疗前后骨转移灶的变化与肿瘤临床综合疗效的相关性。采用Kaplan-Meier法计算生存率,Log-rank检验及Cox回归模型分析影响肺癌或前列腺癌骨转移预后的危险因素。结果肿瘤临床综合治疗有效者(59.68%,37/62)的骨转移疗效明显好于无效者(40.32%,25/62)(P<0.05)。肺癌骨转移患者的1年生存率为54.5%,2年生存率为22.6%;前列腺癌骨转移患者的1年生存率为87.3%,2年生存率为72.3%。单因素及Cox多因素分析均显示:肺癌和前列腺癌骨转移患者的生存率与肿瘤类型及骨转移时长相关(P<0.05)。肺癌与前列腺癌分组行Cox多因素分析结果显示:肺癌骨转移的预后危险因素为病理类型、治疗前骨扫描病变范围及骨转移时长;而前列腺癌骨转移的预后与骨转移时长有关。结论全身骨扫描为肺癌和前列腺癌骨转移的疗效监测及预后判断提供了更丰富、更准确的信息。

Objective To investigate the application of bone scintigraphy in therapy response monitoring and prognosis prediction in patients with bone metastasis from lung cancer and prostate cancer. MethodsWhole-body bone scintigraphy was performed in 40 patients with lung cancer and 31 patients with prostate cancer one month before systematic therapy and no less than 3 months after treatment.The changes of bone metastasis lesions were observed before and after treatment,and the correlation of bone metastasis with therapy response was explored.Survival rates were calculated by Kaplan-Meier method,and prognostic factors for survival were analysed by Log-rank test and Cox regression model. ResultsThe therapeutic effect of bone metastasis in clinical therapy responders in primary tumors（59.68%,37/62） was significantly better than that in clinical therapy non-responders in primary tumors（40.32%,25/62）（P0.05）.The 1-year and 2-year cumulative survival rates of patients with bone metastasis from lung cancer were 54.5% and 22.6% respectively,and those of patients with bone metastasis from prostate cancer were 87.3% and 72.3% respectively.Both univariate analysis and multivariate analysis indicated that tumor type and duration of bone metastasis were related to survival rates of patients with bone metastasis from lung cancer and prostate cancer（P0.05）.Cox regression analysis revealed that pathological type,extent of disease before treatment and duration of bone metastasis were prognostic factors in patients with bone metastasis from lung cancer,and duration of bone metastasis was the prognostic factor in patients with bone metastasis from prostate cancer. ConclusionWhole-body bone scintigraphy provides more abundant and exact information in therapy response monitoring and prognosis prediction in patients with bone metastasis from lung cancer and prostate cancer.