三维适形放疗联合^(89)SrCl_(2)治疗前列腺癌骨转移的效果研究

Study on the Efficacy of Three-dimensional Conformal Radiotherapy Combined with^(89)SrCl_(2)in the Treatment of Bone Metastases from Prostate Cancer

目的探讨三维适形放疗联合^(89)SrCl_(2)对前列腺癌骨转移患者的治疗效果。方法选择前列腺癌骨转移患者(骨转移部位为脊柱/骨盆)60例为对象,信封法分为两组,各30例。对照组采用三维适形放疗,观察组联合^(89)SrCl_(2)治疗,两组均完成3个月治疗,比较两组有效率、视觉模拟疼痛(VAS)、Karnofsky活动状态评分(KPS评分)、白细胞计数、血小板计数、血红蛋白水平、前列腺特异性抗原(PAS)、癌胚抗原(CEA)、I型胶原羧基端肽β特殊序列(β-CTx)、骨转化生化标志物I型前胶原氨基端延长肽(TPINP)、血清睾酮水平及不良反应发生率。结果观察组治疗3个月有效率高于对照组(P<0.05);观察组干预后VAS评分低于对照组(P<0.05);KPS得分高于对照组(P<0.05);观察组干预后WBC、PLT及Hb高于对照组(P<0.05);观察组干预后PAS、CEA、β-CTx、TPINP及血清睾酮水平低于对照组(P<0.05);两组不良反应比较无统计差异(P>0.05)。结论三维适形放疗联合^(89)SrCl_(2)能提高前列腺骨癌转移患者治疗有效率,可减轻前列腺癌骨转移患者疼痛,提高患者生活质量,白细胞、血小板及血红蛋白抑制程度较轻,有助于降低肿瘤标志物水平,且未增加不良反应发生率,值得推广应用。

Objective To investigate the efficacy of three-dimensional conformal radiotherapy combined with^(89)SrCl_(2)in the treatment of prostate cancer with bone metastasis.Methods A total of 60 patients with prostate cancer with bone metastasis(spine/pelvis)were selected as subjects,and were divided into 2 groups with 30 cases in each group by envelope method.The control group was treated with three-dimensional conformal radiotherapy,and the observation group was treated with^(89)SrCl_(2).Both groups completed 3 months of treatment.The response rate,visual analogue pain(VAS),Karnofsky activity status score(KPS score),white blood cell count,platelet count,hemoglobin level,prostate-specific antigen(PAS),carcinoembryonic antigen(CEA),carboxy-terminal peptideβspecial sequence of type I collagen(β-CTX),biochemical marker of bone transformation of type I procollagen were compared between the 2 groups Amino-terminal prolongating peptide(TPINP),serum testosterone level and incidence of adverse reactions.Results The effective rate of the observation group was higher than that of the control group(P<0.05).VAS score of the observation group was lower than that of the control group after intervention(P<0.05).KPS score was higher than the control group(P<0.05);After intervention,WBC,PLT and Hb in the observation group were higher than those in the control group(P<0.05).After intervention,PAS,CEA,β-CTx,TPINP and serum testosterone in the observation group were lower than those in the control group(P<0.05).There was no statistical difference in toxic and adverse reactions between the 2 groups(P>0.05).Conclusion Three-dimensional conformal radiotherapy combined with^(89)SrCl_(2)can improve the effective rate of patients with prostate bone cancer metastasis,reduce the pain of patients with prostate bone cancer metastasis,improve the quality of life of patients with prostate bone cancer metastasis.The degree of leukocyte,platelet and hemoglobin inhibition is less,helps to reduce the level of tumor markers,and does not increase the incidence of adverse reactions,which is worthy of promotion and application.