^(89)Sr联合“云克”治疗前列腺癌骨转移疼痛  

Combining Strontium-89 with ^(99)Tc-MDP for treatment of:painful bone metastases of prostate cancer

作　　者：马玉波[1] 刘平安[1] 顾爱春[1] 徐枫[1] 远奇[1] 王忠[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院核医学科,上海200011 [2]上海交通大学医学院附属第九人民医院泌尿外科,上海200011

出　　处：《中国男科学杂志》2009年第11期23-26,共4页Chinese Journal of Andrology

摘　　要：目的评价^(89)Sr联合"云克"(^(99)Tc-MDP)治疗前列腺癌骨转移性疼痛的临床疗效。方法确认前列腺癌去势术后骨转移伴骨痛患者138例,年龄58～95岁,平均(69.3±8.2)岁,随机分组治疗。(1)对照组73例,单纯^(89)Sr治疗:一次性静注,剂量1.48～2.22 MBq(40～60μCi)/kg。(2)联合组65例,^(89)Sr+云克治疗:^(89)Sr方案,同对照组;云克200mg,每日1次静滴,共计5次。每月一次随访临床疗效,两组对比分析。结果(1)对照组与联合组骨痛缓解总有效率分别为73.97%和90.77%,差异具统计学意义;(2)"闪烁"痛发生率两组分别为30.14%和27.69%,差异无统计学意义;(3)治疗后分别有72.60%和83.08%的病例镇痛药量减少或停用,差异显著;(4)骨痛缓解持续时间,两组各平均为(4.41±1.57)个月和(5.64±2.52)个月,差异具统计学意义;(5)两组治疗后活动能力提高的例数百分比分别为64.38%和81.54%,差异显著。结论^(89)Sr联合云克治疗对缓解前列腺癌骨转移性疼痛有协同作用,可减少镇痛药用量,延长疼痛缓解的持续时间,改善患者的活动能力。Objective To evaluate the clinical efficacy of strontium-89（^89Sr） and ^99Tc-MDP in treatment of painful bone metastases of prostate cancer. Methods total of 138 prostate cancer patients with painful bone metastases, who received emasculate. Their average age of the patients was （69.3±8.2）（from 58 to 95）, were Randomly Divided them into two groups randomly： （1）Control group with only ^89Sr treatment by intravenous injection of 89Sr at the dose of 1.48-2.22 MBq （40-60 μCi）/kg.（7 3 cases）; （2）Combining treatment group（65 cases） with ^89Sr and ^99Tc-MDP, 89Sr dose was same as control group and ^99Tc-MDP 200mg by intravenous transfusion per day, total 5 times（the period of treatment）. Clinical efficacies were evaluated by follow-up analysis once a month. Results （1）The painful alleviated rate was 73.97% and 90.77% in Two groups respectively,The efficacy is significant different. （2）Flare ache occurred rate in 30.14% and 27.6% in the patients of two groups and no sognificant difference was found. （3）After treatment,the number of patients with anodyne reduction was 72.60% and 83.08% respectively,and a significant difference was found. （4）Average continuous time of pain relief was （4.41±1.57） months and （4.64±2.52） months respectively and showed a distinct efficacy. （5）After treatment,the number of patients with advance activity ability was 64.38% and 81.54% in two goups and showed a distinct efficacy.Conclusion Combining ^89Sr and ^99Tc-MDP was an effective method for treatment of painful bone metastases of prostate cancer. They can reduce the dose of anodyne,prolong pain relief time and improve activity ability of the patients.

关 键 词：锶 放射性同位素 前列腺肿瘤/放射疗法 疼痛 

分 类 号：R817.5[医药卫生—影像医学与核医学] R737.25[医药卫生—放射医学]