不同剂量 ^(153)Sm-EDTMP 治疗癌性骨痛疗效的临床观察  

THE CLINICAL COMPARISION OF TWO DOSAGES OF 153SmEDTMP AS PALLIATION OF PAINFUL BONE METASTASES

作　　者：田嘉禾[1,2,3,4] 张锦明[1,2,3,4] 侯庆田 欧阳巧洪[1,2,3,4] 川玲 何义杰[1,2,3,4] 

机构地区：[1]中国人民解放军总医院核医学科 [2]邯郸钢铁公司职工总医院 [3]中国人民解放军304医院 [4]北京海军总医院

出　　处：《同位素》1998年第2期100-105,共6页Journal of Isotopes

基　　金：国际原子能机构区域合作计划(CRP)资助课题

摘　　要：通过国际原子能机构支持的多中心协作，８０例癌性骨痛患者接受单次１５３Ｓｍ－ＥＤＴＭＰ注射，观察单次注射两种不同剂量３７ＧＢｑ／ｇ或１８．５ＧＢｑ／ｇ对癌性骨痛治疗的效果及副作用。以止痛剂用量变化、主观止痛感觉、局部功能改进、化验等临床指标，连续观察１６周。除７例病人在观察期间死亡外，７３例存活者中，止痛有效率８６．３％；两种剂量的止痛效果、止痛时间、副作用类型及程度等指标一致；用药后疗效持续时间（８．２±４．５）周；５０％病例有血相改变，１０例有肝功改变；副作用均在４－６周内恢复；１０例止痛无效，其中９例为男性，６例肺癌。结果证实单次１５３Ｓｍ－ＥＤＴＭＰ注射是有效的骨痛姑息治疗技术；但对终晚期或伴其他组织转移病例，没有根本性改善作用；止痛疗效与副作用均与剂量无关；男性、肺癌病例治疗无效可能性大。用１５３Ｓｍ－ＥＤＴＭＰ治疗癌性骨痛，确实需要进一步客观、科学评价。ifferent dosages of 153SmEDTMP are injected intravenously into 80 patients of bone pain caused by metastases. The patients are selected according to IAEA creteria and received 153SmEDTMP in dosage of 37 GBq/g or 18.5 GBq/g. The efficacy and the sideeffects are evaluated in the following 16 weeks. Improvement of symptom, general condition and change of analgestic concumption are carefully recorded, so are the Lab findings. Seven patients died before the end of the study. In the rest 73 cases, 63 cases show the evidence of palliation, the total response rate after single dose of 153SmEDTMP is 86.3%. The effect persisted for 8.2±4.5 weeks. Nearly 50% of the cases have blood count drops, 10 cases have the evidence of liver damage. All sideeffects disappeared after 6-8 weeks. 9 of 10 nonresponding cases are male, 6 of them suffer from lung cancer. In conclusion, single injection of  153SmEDTMP is effective in treating painful bone metastases, the efficacy and sideeffects are both dosageindependents; male or lung cancer might bear higher risk of being not responding to the therapy. A deeply insighted study is justified for further verification of 153SmEDTMP palliative therapy.

关 键 词：骨转移 骨痛 钐153 EDTMP 肿瘤 治疗 

分 类 号：R730.55[医药卫生—肿瘤] R817.58[医药卫生—临床医学]