Metastron治疗骨转移灶所致骨痛临床初步应用  

Preliminary clinical study of ^(89)Sr in palliation in painful skeletal metastases

作　　者：管一晖[1] 林祥通[1] 刘永昌[1] 金少津[1] 薛方平[1] 蒯大禹[1] 张锦明[1] 

机构地区：[1]复旦大学附属华山医院,上海200040

出　　处：《核技术》2001年第5期350-354,共5页Nuclear Techniques

摘　　要：为了验证进口英国Amersham公司出品的Metastron( 89SrCl2 注射液 )对肿瘤骨转移所致疼痛的止痛效果及其使用的安全性 ,按卫生部药政局特药处批准要求进行。 2 5例符合入选标准患者 ,并经过疼痛评分 ,其骨痛评分范围在 6— 16分之间 ,按说明书应用 1.4 8MBq kg的剂量后 ,进行规范的随访 ,并对患者的骨痛疗效进行评估 ,同时观察即刻不良反应和血液学、肝肾功能的变化。结果发现 ,Metastron注射后对肿瘤骨转移所致疼痛有明显的止痛效果 ,总有效率 72 % ,提高了患者的生存质量。在不良反应观察中可以看到 ,Metastron静脉注射后 ,在患者中观察到骨髓抑制的表现 ,其中 32 %患者发现有白细胞减低 ,60 %患者有血小板数减低 ,除 1例患者外 ,其余患者可以恢复至正常 ,该例未能恢复的患者尚可观察到短期的肝功能异常表现 ,故在治疗过程中尚须密切观察肝、肾功能的变化。治疗过程中 ,在注射Metastron后 ,55.5%患者有一过性疼痛加剧表现 ,大多数在治疗 3— 7d后可消失 ,仅 1例患者延续至 2 0d后方缓解。在接受治疗的患者中 ,疗效以前列腺癌、乳腺癌骨转移所致骨痛为较好。对有疗效的患者 ,疗效持续时间根据目前随访资料 94 .4 %的患者疗效维持时间均在 3个月以上 ,仅 1例患者 ( 5.6% )的疗效维持时间为 2个月。According to the requirements of department of special drug, bureau of drug administration, Chinese ministry of health, To testify the safety and efficiency of metastron injection solution imported from the Amersham Company, U.K. being underged. 27patients were treated with metastron for metastatic bony pain(MBP). 2 cases were excluded by interrupted follow-up, the other 25 cases with metastatic prostate carcinoma, lung cancer, breast cancer were evaluated in a standard quantitative pain measurement before the treatment.Pain scores of these patients were between 6—16. 1.48MBq/kg metastron was given intravenous. All the patients were observed at least 3 months. Pain score, immediate adverse reaction were observed . Results shown that clinical significant metastastic pain relief can be observed in most patients. Total efficiency was 72%, patients' life quality have been improved. There was mild decrease of white blood cell in 32% and platelet counts in 60% patients, but can recovered in most patients temperary except 1. In this case, liver function abnormal was also appeared. Significant increased pain (flare) occurred in 55.5% patients after the injection, the flare up pain had been lasting 3—7days, only one lasting more than 20 days. It was concluded that 89 Sr is most effective in palliative therapy for MBP in-patient with prostate or breast carcinoma. In 94.4 % patients , the pain relief can lasted more than 3 months, but only one patient for 2 months.7 cases had repeated the bone scan after therapy,but no significant changes can be observed. There by 89 Sr was safe and effective for the treatment of MBP.

关 键 词：骨转移 骨痛 放射性核素治疗 病灶 骨转移癌 Metastron 

分 类 号：R738.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]