乳腺癌多发性骨转移的预后和^153Sm—EDTMP治疗结果  

Prognosis of breast cancer patients with multiple bone metastasesand therapeutic effect of 153samarium EDTMP

作　　者：郑容[1] 曹秀华[1] 李家秀[1] 刘琳[1] 贾莹莹[1] 吴文凯[1] 唐谨[1] 陈盛祖[1] 

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

出　　处：《癌症》2000年第8期795-798,共4页Chinese Journal of Cancer

摘　　要：分析乳腺癌多发性骨转移的预后和153Sm 乙二胺四甲基膦酸 (EDTMP)治疗结果。方法 :回顾分析1992年至1998年131例接受了153Sm EDTMP治疗的乳腺癌多发性骨转移病人。所有病人经病理或细胞学证实为乳腺癌。骨转移灶经骨显像、X光片、CT和/或MRI诊断证实。结果 :全组病人总的5年生存率为59 % ,骨转移后5年生存率和中位生存期分别为18 5 %和15个月。转移局限于骨的病人比骨转移合并其它部位转移的病人生存期长 ,其相应的骨转移后5年生存率分别为26 3 %和13 7 %。所有多发性骨转移疼痛病人接受153Sm EDTMP治疗,治疗有效率为81 7 % ,其中完全缓解34 4 % ,部分缓解47 3 % ,无效率为18 3 %。骨核素治疗效果和预后相关 ,完全缓解的病人骨转移后生存率明显优于部分缓解或无效病人 ,其5年生存率分别为32 8 % ,10 4 %和11 4 % (P<0 001)。结论 :乳腺癌骨转移是一个相对缓慢的临床过程 ,153Sm EDTMP是多发性骨转移疼痛的有效治疗手段 。Objective: To analyze the prognosis of breast cancer patients with multiple bone metastases and evaluate therapeutic effect of 153Sm EDTMP to the patient Methods: Between 1992 and 1998, 131 breast cancer patients with painful multiple bone metastasis treated with 153Sm EDTMP were retrospectively reviewed All patients were histologically confirmed as breast cancer Bone metastasis was further diagnosed with ECT, X ray, CT and/or MRI Results: The overall 5 year survival rate for all patients was 59% The post bone metastasis 5 year survival rate was 18 5%and median survival time was 15 months Patients with metastasis disease confined to the skeleton had a longer survival as compared to those with both bone and local regional or other distant metastases (P<0 001) The corresponding post bone metastasis 5 year survival was 26 3%and 13 7%, respectively All patients with painful multiple skeletal metastases treated with 153Sm EDTMP got positive response of 81 7 %,(complete response 34 4%and partial response 47 3%), while twenty four (18 3%) patients showed no response The efficacy of 153Sm EDTMP was associated with prognosis The post bone metastasis survival for patients with complete response was significantly better than those with partial or no response The corresponding post bone metastasis 5 year survival was 32 8%,10 4%, and 11 4%, respectively (P<0 001) Conclusion: Breast cancerpatient with skeletal metastases is an indolent clinical course 153Sm EDTMP is an effective agent for these patients with painful multiple bone metastases and its efficiency is an important prognostic factor

关 键 词：乳腺癌 骨转移 预后 ^153SM-EDTMP 

分 类 号：R737.9[医药卫生—肿瘤]