^(89)Sr(锶)治疗前列腺癌骨转移的初步应用  

Preliminary Application of Strontium-89 for the Treatment of Bone Metastases from Prostate Cancer

作　　者：赵卫威[1] 邓候富[1] 解朋[2] 青春 张锡英[1] 

机构地区：[1]四川大学华西医院核医学科,成都610041 [2]河北医科大学第三医院核医学科,石家庄050051 [3]成都363医院核医学科,成都610041

出　　处：《生物医学工程学杂志》2010年第6期1251-1254,共4页Journal of Biomedical Engineering

摘　　要：临床上对前列腺癌骨转移患者的处理主要是治疗转移性骨疼痛。尽管使用了止痛药物治疗疼痛,但结果并不理想8。9锶(89Sr)发射纯β射线,在成骨组织活跃的部位有亲和力。本研究评价了放射性89Sr对治疗前列腺癌骨转移的临床效果。116例前列腺癌患者接受静脉注射3 mCi(111 MBq)89Sr治疗。用药前后均进行体检,按Karnofsky行为评分,记录相应症状、体征和各项实验室参数;采用疼痛记分观察疗效,总分>75%为显效(CR),25%<总分<75%为部分有效(PR),总分<25%为无效(NR);用WHO标准中X射线(CT、MRI)9、9mTc-MDP骨显像随访骨转移病灶的变化并进行评判。结果显示,89Sr治疗的总有效率为80.2%。其中CR为18.1%(21/116),PR为62.1%(72/116),NR为19.2%(23/116);Karnofsky行为评分平均改善约20%;1/3患者病灶数量减少或转移病灶消失;13例(13/116,12%)患者的PSA降低;89Sr对造血系统无明显影响。提示,89Sr治疗前列腺癌骨转移是一种安全有效的方法。Bone metastases are a major problem in the clinical management of patients with prostate cancer.Despite the use of analgesic for the relief of such pain,the outcomes are not often satisfactory.Strontium-89（89Sr） is a pure betaemitting radioisotope to be avidly concentrated in the areas of high osteoblastic activity.The aim of this study was to evaluate the efficacy of 89Sr in the therapy for bone metastases of prostate carcinoma.116 patients received intravenous injection of 89Sr at the dose of 3mCi（111MBq）.All patients underwent physical examination and Karnofsky＇s Performance Score（KPS） evaluation before and after administration;the analgesic effects were evaluated by scores of pain.The complete response（CR） was defined as scores of pain 75%;no response（NR） was defined as scores of pain 25%;the remaining was partial response（PR）.The changes of bone metastases were screened by CT,MRI and 99mTc-MDP bone scintigraphy according to the standards of WHO.After the treatment with 89Sr,the total response rate was 80.2%.In the 116 cases,21 cases（18.1%） displayed complete response and 72 cases（62.1%） displayed partial response,but 23 cases（19.2%） showed no response.The mean score on Karnfsky＇s performance status（KPS） was 20.0% higher.About 1/3 cases exhibited an obvious decrease in the number of metastases,and some foci disappeared.Thirteen cases（12%） showed a greater decrease in prostate-specific antigen（PSA） value.89Sr chloride is an effective and safe therapy of the bone metastases from prostate cancer.

关 键 词：89锶 前列腺癌 骨转移 止痛 肿瘤消退 

分 类 号：R737.25[医药卫生—肿瘤]