钐^(153)-乙二胺四撑膦酸改善骨转移患者癌性疼痛  

Samarium 153 ethylenediamine tetramethylene phosphonic acid for the improvement of carcinomatous pain in patients with bone metastasis

作　　者：陈璟[1] 胡健[1] 周健[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院核医学科,湖北省武汉市430030

出　　处：《中国临床康复》2005年第22期28-29,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:对钐153-乙二胺四撑膦酸治疗的转移性骨肿瘤患者进行随访调查,探讨其治疗骨转移性癌痛的效果,并分析年龄、性别、原发肿瘤的类型以及治疗前Karnofasky评分、疼痛严重程度和止痛剂使用分级的相关性。方法:在接受钐153-乙二胺四撑膦酸治疗的转移性骨肿瘤患者中,选取158例进行16周的随访。该组患者具有不同程度的癌痛,并能够合作汇报、记载癌痛的症状;预期寿命>6个月;接受治疗前至少4周未行放射治疗和抗肿瘤药物治疗;无肝、肾及其他重要器官功能障碍;无病理性骨折或其他机械性失稳的临床和放射学表现;白细胞>4.0×109L-血小板>100×109L-1。随访内容包括:疼痛程度、止痛剂的使用、Karnofsky评分、血常规及血生化学变化。用骨痛缓解情况和止痛剂使用的变化评价治疗效果。同时分析疗效与年龄、性别、原发肿瘤的类型以及治疗前Karnofasky评分、疼痛严重程度和止痛剂使用分级的相关性。结果:158例患者均进入结果分析。①127例骨痛减轻,125例止痛剂使用减少。Karnofsky评分治疗前为57.8±27.6,治疗后增加为66.4±24.4。②最常见副反应为可逆性骨髓抑制。③BinaryLogistic回归分析示仅原发肿瘤的类型可能是影响钐153-乙二胺四撑膦酸疗效的主要因素(OR=1.8),对肺癌性性疼痛的止痛效果低于乳腺癌和前列腺癌性疼痛,而后者之间止痛效果比较基本接近。结论:钐153-乙二胺四撑膦酸对各种骨转移癌引起的疼痛有不同程度的止痛效果,原发肿瘤的类型是影响止痛效果的主要因素。AIM:To evaluate effects of samarium 153 ethylenediamine tetramethylene phosphonic acid(153Sm-EDTMP) on metastatic carcinomatous pain of bone in patients with metastatic bone carcinoma by survey and follow-up,and analyze the association among age,gender,type of primary carcinomas,pre-treatment Karnofasky scores,severity of pain and consumption grading of analgesic. METHODS:Totally 158 patients with carcinomatous pain of different degrees selected from those with metastatic bone carcinomas were treated with 153Sm-EDTMP,and then they were followed up for 16 weeks with cooperatively reported and recorded carcinomatous pain.Their expectant life was longer than 6 months,and they did not receive radiotherapy and anti-tumor drug treatment at least 4 weeks before treatment.Dysfunction of liver,kidney and other important organs was not found,so was not the clinical and radiological manifestation of pathologic fracture or other mechanical imbalance.Their white cells were more than 4.0×109 L-1,and blood platelets more than 100×109 L-1.They were followed up in terms of severity of pain,consumption of analgesic,Karnofsky scoring,routine examination of blood and biolochemical changes of blood.The changes in relief of bone pain and consumption of analgesic were detected to evaluate the therapeutic effect.Relationships of therapeutic effect with age,gender,type of primary carcinomas,pre-treatment Karnofasky scores,severity of pain and consumption grading of analgesic were analyzed. RESULTS:All the 158 patients were included in the result analysis.①Of 158 patients,a relieved pain was achieved in 127 cases,a reduction of analgesic consumption was found in 125 cases.Karnofsky score increased from 57.8±27.6 before treatment to 66.4±24.4 after treatment.②The most common side reaction was reversible myelosuppression.③Shown by Binary Logistic regression analysis,only the type of primary carcinomas was the major factor that influenced the therapeutic effect of 153Sm-EDTMP(OR=1.8);Analgesic effect of 153Sm-EDTMP on lung carcinom

关 键 词：放射疗法 骨肿瘤/继发性 疼痛/放射疗法 

分 类 号：R441.1[医药卫生—诊断学]