^(153)Sm-EDTMP 治疗肺癌骨转移

^(153)Sm-EDTMP in the treatment of bone metastasis of lung cancer

目的 探讨1 53Sm EDTMP治疗肺癌骨转移的临床效果。方法 1 1 0例肺癌伴骨转移的患者接受该治疗。采用两次给药法 ,第一次先注射示踪剂量 ,分别计算尿排谢率、骨摄取率、骨累积活性、红骨髓的吸收剂量、总用药量以后 ,再注射第二次剂量。结果 疼痛完全缓解者 38例 ,中度缓解者 6 0例 ,总止痛有效率为 89.1 % (98/1 1 0 )。患者疼痛缓解出现的时间为 3h～ 4周 (7.5d± 6 .3d) ,疼痛完全缓解维持的时间范围为 2～ 4周。 1 1 0例中有 1 2例病灶消失 (CR) ,Karnofsky评分上升 2 0分左右 ,减少或取消止痛药 ;2 0例患者转移病灶数量减少、病灶缩小 (PR) ,Karnofsky评分上升 1 0～ 1 5分。转移灶治疗总有效率为 2 9.1 % (32 /1 1 0 )。 35例患者的白细胞和血小板计数与治疗前比较 ,有明显减少 ,1～ 3月后恢复到治疗前水平。结论 1 53Sm EDTMP治疗肺癌骨转移是一种安全。

Objective To explore the clinical effect of 153 Sm EDTMP therapy in the treatment of bone metastasis of lung cancer. Meth ods On e hundred and ten patients with painful bone metastasis were entered into this s tudy. The patients were administrated with two steps. At first, they were inject ed with tracer dose of 153Sm EDTMP. After a series of index were calculated, such as urine discharge, bone uptake, cumulated skeletal activity, absorbed dose of red marrow and total dose, the second injection was given. WTHZ Results Of 110 cases, 98(89.1％) experienced pain relief with complete respons e in 38 cases and partial response in 60 ones. Pain relief occurred from 3?h to 4 weeks(7.5?d±6.3?d）. Duration of pain relief from single injection ranged from 2 to 4 weeks. Follow up imag ing studies were performed within 3 months. In 12 cases, metastatic foci disappe ared completely (CR), Karnofsky score increased by 20, and analgesic were discon tinued. In 20 patients, both number and diameter of metastatic foci decreased (PR), with an improvement in Karnofsky score ranging from 10 to 15. There were significan t decreases in WBC and platelet count found in 35 of 110 patients after therapy, however, blood cell counts returned to baseline within 1 to 3 months. WTHZ C onclusion 153Sm EDTMP has proven to be a safe and effective therapy for bone pain in lung cancer, and often results in shrinkage or disappearance of metastatic foci.