Bone metastases have a major impact on quality of life and survival of patients with advanced prostate cancer,in the last decade,the development and approval of substances inhibiting the vicious cycle of bone metastas...Bone metastases have a major impact on quality of life and survival of patients with advanced prostate cancer,in the last decade,the development and approval of substances inhibiting the vicious cycle of bone metastases have enabled the reduction of complications caused by bone metastases in patients with castration-resistant prostate cancer.These drugs have raised awareness of the importance of skeletal-related events which in the meantime represent an important end point also in trials using agents not specifically designed for bone lesions.Second-generation antihormona]drugs such as enzalutamide or abiraterone have been shown to have a positive impact on the incidence of skeletal complications and therefore provide an important tool in the armamentarium used for treating bone metastases.Radiopharmaceuticals such as radium-223 dichloride([^223Ra])have been demonstrated not only to reduce skeletal-related events and bone-related pain,but also to prolong overall survival,thereby being the first bone-targeting agent showing a survival benefit.As previous studies have not provided an obvious benefit of bone-targeted lesions in castration-sensitive disease,the use of these agents is not recommended.In oligometastatic prostate cancer,the role of local treatment of metastases using stereotactic radiation or radiosurgery is a matter of intense debates and may play an increasing role in the future.展开更多
目的:运用行为药理学方法,观察前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)在骨癌痛(cancer-induced bone pain,CIBP)大鼠脊髓的镇痛效应。方法:本研究用SD雌性大鼠30只,随机分为5组(n=6):假手术+生理盐水(Ⅰ组)、假手术+hPAP(Ⅱ...目的:运用行为药理学方法,观察前列腺酸性磷酸酶(prostatic acid phosphatase,PAP)在骨癌痛(cancer-induced bone pain,CIBP)大鼠脊髓的镇痛效应。方法:本研究用SD雌性大鼠30只,随机分为5组(n=6):假手术+生理盐水(Ⅰ组)、假手术+hPAP(Ⅱ组)、模型+生理盐水(Ⅲ组)和模型+hPAP(Ⅳ组)、空白对照组(Ⅴ组)。麻醉后,Ⅰ组和Ⅱ组右侧胫骨骨髓腔内注入5μl生理盐水;Ⅲ组和Ⅳ组于右侧胫骨骨髓腔内接种5μl大鼠乳腺癌细胞(2×105个),14d后造模完成。接种后第15天Ⅰ、Ⅲ组鞘内分别给予5μl生理盐水,Ⅱ、Ⅳ组鞘内分别给予5μl hPAP(1U),接种后第17天,Ⅳ组腹腔注射选择性腺苷A1受体拮抗剂8-环戊基1,3-二丙基黄嘌呤(8-cyclopentyl-1,3-dipropylxanthine,CPX)。于接种前、接种后第3、6、9、12、15、16、17、18、19、20和21天分别测量大鼠的机械性和热刺激的缩足阈值。结果:PAP对骨癌痛模型大鼠具有良好的镇痛效果,且镇痛效应能维持3d左右,未观察到运动阻碍、成瘾及耐受等不良反应;CPX可以基本翻转PAP在脊髓水平对痛觉传递的抑制作用。结论:PAP可能成为一个新的治疗癌性痛的潜在药物分子。展开更多
文摘Bone metastases have a major impact on quality of life and survival of patients with advanced prostate cancer,in the last decade,the development and approval of substances inhibiting the vicious cycle of bone metastases have enabled the reduction of complications caused by bone metastases in patients with castration-resistant prostate cancer.These drugs have raised awareness of the importance of skeletal-related events which in the meantime represent an important end point also in trials using agents not specifically designed for bone lesions.Second-generation antihormona]drugs such as enzalutamide or abiraterone have been shown to have a positive impact on the incidence of skeletal complications and therefore provide an important tool in the armamentarium used for treating bone metastases.Radiopharmaceuticals such as radium-223 dichloride([^223Ra])have been demonstrated not only to reduce skeletal-related events and bone-related pain,but also to prolong overall survival,thereby being the first bone-targeting agent showing a survival benefit.As previous studies have not provided an obvious benefit of bone-targeted lesions in castration-sensitive disease,the use of these agents is not recommended.In oligometastatic prostate cancer,the role of local treatment of metastases using stereotactic radiation or radiosurgery is a matter of intense debates and may play an increasing role in the future.
