^(89)Sr和^(153)Sm-EDTMP治疗鼻咽癌多发性骨转移瘤疗效的比较  

Comparison of treatment result with ^(89)Sr and ^(153)Sm-EDTMP in NPC patients with bone metastases

作　　者：樊卫[1] 许光普[2] 曾宗渊[2] 刘枫 

机构地区：[1]中山医科大学肿瘤防治中心核医学科,广东广州510060 [2]中山医科大学肿瘤防治中心头颈外科,广东广州510060 [3]广州市肿瘤医院核医学科,广东广州510095

出　　处：《癌症》2000年第6期586-588,共3页Chinese Journal of Cancer

摘　　要：目的：比较^(８９)Ｓｒ和^(１５３)Ｓｍｉｎ－ＥＤＴＭＰ治疗鼻咽癌（ｎａｓｏｐｈａｒｙｎｇｅａｌ ｃａｒｃｉｎｏｍａ， ＮＰＣ）多发性骨转移瘤的疗效。方法：从１９９７年５月到１９９９年３月，作者用^(８９)Ｓｒ和^(１５３)Ｓｍ－ＥＤＴＭＰ分别治疗ＮＰＣ多发性骨转移瘤病人４５例和６８例。根据治疗前后骨痛缓解和生活质量的情况决定疗效，同时比较其病灶摄取放射性变化，观察开始起效的时间，对病人血清ＶＣＡ－ＩｇＡ、ＥＡ－ＩｇＡ水平和骨髓造血功能的影响。结果：^(８９)Ｓｒ和^(１５３)Ｓｍ－ＥＤＴＭＰ治疗ＮＰＣ多发性骨转移瘤的有效率分别为 ８６． ７％和 ８８.２％，治疗后起效的时间为 １１.０和 ７.２天；治疗前后和两组骨转移灶 ＲＯＩ值变化、对 ＮＰＣ病人血清 ＶＣＡ－ＩｇＡ、ＥＡ－ＩｇＡ水平和外周血相的影响有显著性差别（ Ｐ＜ ０．０５）。结论：^(８９)Ｓｒ和^(153)Ｓｍ－ＥＤＴＭＰ对 ＮＰＣ骨转移病人的疼痛缓解和生活质量的提高有肯定疗效。^(１５３)Ｓｍ－ＥＤＴＭＰ对ＮＰＣ骨转移灶的抑制作用明显强于^(８９)Ｓｒ，可以部分降低ＶＣＡ－ＩｇＡ和ＥＡ－ＩｇＡ水平。～（１５３）Ｓｍ－ＥＤＴＭＰ的骨髓毒性较^(８９)Ｓｒ严重。Objective: To compare treatment result of ^(89)Sr and ^(153)Sm-EDTMP in nasopharyngeal carcinoma (NPC) patients with bone metastases. Methods: NPC patients with bone metastases were treated using ^(89)Sr (45 cases) or ^(153)Sm-EDTMP (68 cases). The effectiveness was determined by pain relief and life quality improvement, changes of bone morrow function and VCA-IgA, EA-IgA level. Results: The response rate to ^(89)Sr and ^(153)Sm-EDTMP was 86.7% and 88.2%. respectively (P>0.05). The effective period following treatment was 11.0 and 7.2 days, and bone morrow repression rate was 22% and 42%, respectively. These differences were significant (P<0.02). The influence to serum VCA-IgA and EA-IgA level, and radioactive uptake of bone lesion ROI following ^(89)Sr or ^(153)Sm-EDTMP treated was significantly different (P <0.05). Conclusions: ^(89)Sr and ^(153)Sm-EDTMP can relief bone pain and improve patient's life quality. ^(153)Sm-EDTMP may repress bone metastases stronger than ^(89)Sr, and can decrease patient's serum VCA-IgA and EA-IgA level, but the blood toxity is also more serious than ^(89)Sr.

关 键 词：鼻咽肿瘤 继发性骨肿瘤 ^89SR ^153SM-EDTMP 

分 类 号：R739.63[医药卫生—肿瘤]