烟酰胺和碳合氧增敏^(89)Sr治疗多发性骨转移癌的临床研究  

Clinical study of ^(89)Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms

作　　者：刘雅洁[1] 王树滨[1] 郭一玲[2] 陈佐伟 张英男[2] 

机构地区：[1]暨南大学医学院附属第二医院暨深圳市人民医院肿瘤科,深圳518020 [2]暨南大学医学院附属第二医院暨深圳市人民医院核医学科,深圳518020

出　　处：《中华放射医学与防护杂志》2005年第6期545-547,共3页Chinese Journal of Radiological Medicine and Protection

基　　金：广东省自然科学基金资助项目(000372)

摘　　要：目的评价烟酰胺和碳合氧(Carbogen)增敏89Sr治疗多发性骨转移癌的作用、骨痛的缓解及毒副反应。方法97例恶性肿瘤多发性骨转移患者随机分为4组烟酰胺+Carbogen+89Sr治疗组(A组);烟酰胺+89Sr治疗组(B组);Carbogen+89Sr治疗组(C组);89Sr治疗组(D组)。89SrCl2治疗采用1.48～2.22MBq/kg,静脉注射。注射89Sr前1h开始给予烟酰胺,6g/d,分3次口服,连服5d。首次口服烟酰胺后开始吸入Carbogen(95%O2+5%CO2)气体,6L/min,10min,每日1次,连续5d。结果A组治疗后骨痛的缓解及生活质量较B组、C组及D组有效率高(91.7%、77.3%、76.0%和69.2%),且A组与D组比较差异有统计学意义(P=0.048)。治疗后3个月复发性骨转移癌全身骨显像反应,各组之间差异无统计学意义。各组病人治疗后均有Ⅰ～Ⅱ度骨髓抑制,各组之间差异无统计学意义。结论烟酰胺+Carbogen+89Sr治疗多发性骨转移癌,对骨痛的缓解及生活质量的改善有更好的疗效,且未增加89Sr的治疗毒性反应。Objective To evaluate the curative effect and side effects of ^89 Sr therapy with radiosensitization by nicotinamide and carbogen in multiple bone metastasis of malignant neoplasms. Methods Ninty-seven patients were divided into 4 groups respectively： group A,^89Sr ＋ nicotinamide ＋ carbogen（24 patients）; group B,^89Sr ＋ nicotinamide（22 patients）; group C,^89Sr ＋ carbogen（25 patients）; group D,^89Sr, （26 patients）. ^89SrCl was intravenously injected at a dose of 1.48-2.22 MBq/kg. Nicotinamide was taken orally 1 hour before ^89 SrCl injection, 6 g/day, tid, d1 -d5. Aspiration of carbogen（95 % O2± 5 % CO2 ） gases, 6 L/min, 10 minuts, qd, d1-d5. Results The effective rate of pain control and QOL improvement in A group were higher than in groups B, C and D （91.7% VS 77.3% ,76.0% and 69.2% , P = 0.048 ）. The lesions assessed by SPECT imaging in every group was not significantly different at three months after treatment. Ⅰ to Ⅱ degree toxic effect on bone marrow appeared in every group and there were no significantly inter-group differences. Conclusions Combinative therapy using ^89 Sr ＋ nicotinamide ＋ carbogen is more effective to treat multiple metastatic bone pain and for improvement of QOL. The side effects are not increased.

关 键 词：恶性肿瘤 骨转移 ^89SR 烟酰胺 碳合氧 

分 类 号：R738.1[医药卫生—肿瘤]