^(89)Srcl_2内照射治疗肿瘤转移性骨痛的临床研究

背景与目的恶性肿瘤骨转移是多数晚期肿瘤患者面临的严重问题之一。乳腺癌、前列腺癌和肺癌等恶性肿瘤晚期多伴发骨转移,且多部位的骨骼受累在临床极为常见，其中约50％的患者伴有持续且日益加重的剧烈骨痛，严重影响患者的生存质量。传统的治疗方法包括使用镇痛药物、外照射治疗、化疗以及手术治疗等，其临床疗效有限，且副作用较大。放射性核素氯化锶（^89Srcl2）是一种发射β射线的放射性核素，生化特性与钙类似，静脉注射后约50％聚集于骨，骨转移病灶的摄取率及滞留量均明显高于周围正常骨组织。自90年代末国内开始引进^89Srcl2用于肿瘤转移性骨痛的治疗，初步的临床应用已证实其疗效肯定。本研究的目的是进一步探讨和评价^89Srcl2治疗转移性骨肿瘤的应用范围、疗效及副作用。

帕米磷酸二钠治疗恶性肿瘤转移性骨痛的近期疗效观察

恶性肿瘤晚期常并发骨转移,尤以乳癌、肺癌、前列腺癌和鼻咽癌等多见,其特点与晚期肿瘤的脑肝转移不同,如治疗得当部分骨转移癌患者虽不能治愈却能带瘤长期生存.文献报道,大约50%的癌症患者死后尸解发现有骨转移.其中近半数临床上出现症状[1],其主要症状为难以控制的进行性骨痛.

综合治疗肿瘤转性骨痛的疗效观察及护理

目的 探索控制肿瘤转移性骨痛方法。方法 采用放化疗、骨膦或阿可达及使用止痛药物 ,联合治疗中度以上疼痛病人 48例 ,在全面、系统的护理下 ,对镇痛效果及生活质量进行了观察。结果 疼痛的显著缓解率 85 .4% (41/48) ,疼痛程度减轻 ;生活质量改善 ,治疗后Qol平均分增加 7.91± 0 .2 6。结论 积极有效的综合治疗和系统的护理 ,是控制肿瘤转移性骨痛 ,提高患者生活质量的重要措施。

Clinical research on zoledronic acid in treatment of pain caused by bone metastasis of malignant tumors

Objective:To evaluate the efficacy and safety of zoledronic acid for the pain caused by metastatic tumor of bone.Methods:52 patients with metastatic tumor of bone were randomly divided into two groups.The zoledronic acid group received 4 mg zoledronic acid infusion for 30 minutes and the control group received 90 mg pamidronate infusion for 6 hours. Results:The effective rates in zoledronic acid group and control group were 73.08%and 69.23%respectively.No significant difference was observed between the two groups.The median pain relief onset at days 5 and 7,respectively,and no significant difference was observed.The ECOG scores on the 7th day after medication:the differences in the zoledronic acid group before and after medication and between the two groups were both significant(P<0.001 and P=0.0448).The adverse reac- tion was no significant difference between the two groups.Conclusion:Zoledronic acid is efficient and safe in the treatment of pain caused by metastatic tumor of bone and it has low adverse reaction rate and convenient shorter using time.