^(153)Sm-EDTMP 治疗肺癌多发性骨转移疼痛的疗效分析  

Treatment with ^(153) Sm-EDTMP for Lung Cancer Patients with Painful Multiple Bone Metastases

作　　者：郑容 陈盛祖[1] 刘琳[1] 贾莹莹 李家秀 唐谨 

机构地区：[1]中国协和医科大学肿瘤医院核医学科,中国医学科学院100021

出　　处：《实用癌症杂志》2000年第3期297-299,共3页The Practical Journal of Cancer

摘　　要：目的　分析153 Sm 乙二胺四甲基磷酸 (EDTMP)治疗肺癌多发性骨转移疼痛的疗效及毒副作用。方法　对 1992年至 1998年 115例经病理或细胞学诊断证实的肺癌多发性骨转移疼痛病人做单次或多次153 Sm EDTMP核素止痛治疗。 115例原发灶中 ,腺癌 5 9例 ,小细胞未分化癌 13例 ,鳞癌 18例 ,肺泡细胞癌 2例 ,未分类 2 3例。骨转移灶经骨显像、X线摄片、CT和 (或 )MRI诊断。结果　全组总的治疗有效率为 65 .2 % (其中完全缓解为 19.1% ,部分缓解为 46.1% ) ,无效率为 3 4 .8%。鳞癌骨痛治疗有效率为 72 .2 % ,腺癌为 66.1% ,小细胞肺癌为 61.5 % ,但无显著性差异。未见严重的毒副反应 ,仅有 2 7% ( 3 1/115 )的病人出现不同程度的白细胞、血小板及血红蛋白下降。结论　153 Sm EDTMP静脉注射是肺癌多发性骨转移疼痛的有效治疗手段 ,暂时性、可逆性骨髓抑制是常见的副作用。Objective To evaluate the efficacy and toxicity of samarium 153 ethylene diamine tetramethylene phosphonate( 153 Sm EDTMP) as a palliative treatment for lung cancer patients with painful multiple bone metastasis.Methods Between 1992 and 1998,one hundred and fifteen lung cancer patients with painful multiple bone metastasis were treated with 153 Sm EDTMP at a varying dose of 25.9～37.0 MBq/kg.All diagnosis was histologically or pathologically confirmed.There were 18 patients with squamous cell carcinoma,59 adenocarcinoma,12 small cell lung cancer and 23 unclassified.Bone metastasis was further diagnosed with ECT,X ray,CT and/or MRI.Results 65.2% of patients had a positive response,with complete response 19.1% and partial response 46.1%.34.8% of patients showed no response.According to pathology,the positive response was observed in 39 of 59( 66.1% ) patients with adenocarcinoma,13 of 18(72.2%) patients with squamous cell carcinoma,and 8 of 13(61.5%) patients with small cell lung cancer.No serious side effect was observed,except for falls in the white blood cells,platelet counts,hemoglobin in 27%(31/115) of patients.Conclusion 153 Sm EDTMP is an effective treatment for lung cancer with painful multiple bone metastasis.The most common side effect is temporary myelosuppression.

关 键 词：肺癌 骨转移疼痛 ^153SM-EDTMP 治疗 疗效 

分 类 号：R734.205[医药卫生—肿瘤] R738.105[医药卫生—临床医学]