^(153)Sm-EDTMP治疗癌性骨痛的影响因素  

A study about influencing factors of ~ (153)Sm-EDTMP as a palliative treatment for painful skeletal metastases

作　　者：欧阳巧洪[1] 田嘉禾[2] 滕小梅[1] 刘加昌[1] 张瑾[1] 文志道[1] 

机构地区：[1]解放军304医院核医学科,北京100037 [2]北京解放军总医院核医学科

出　　处：《中华核医学杂志》2002年第5期291-293,共3页Chinese Journal of Nuclear Medicine

基　　金：国际原子能机构 (IAEA)基金资助项目 (E1 .30 .1 3)

摘　　要：目的　探讨15 3 Sm 乙二胺四亚甲基膦酸 (EDTMP)治疗癌性骨痛效果的影响因素。方法对 76例首次应用15 3 Sm EDTMP治疗的肿瘤骨转移疼痛患者 ,分别按主要疼痛部位、原发癌类型、病灶骨与正常骨组织 (T/NT)放射性比值、骨转移灶数目、骨转移灶占全身骨骼放射性总计数的百分率以及骨转移灶占全身骨骼总面积的百分率进行分组疗效与统计检验 ,并对以上 6种因素及性别、年龄和治疗剂量进行单因素与多因素回归分析。结果　 76例患者首次治疗后疼痛缓解的总有效率为6 9 74 %。前列腺癌和乳腺癌疗效明显好于肺癌 ( χ2 =1 1 .1 86 ,P <0 .0 1 ) ;腰痛和腰痛伴其他部位疼痛疗效明显好于髋关节或下肢疼痛 ( χ2 =1 8.980 ,P <0 .0 1 ) ;T/NT比值为 1 .2～ 2 .0时疗效明显好于T/NT <1 .2 0时 ( χ2 =1 2 .894 ,P <0 .0 1 )。多因素回归分析提示影响疗效的显著因素依次为主要疼痛部位、原发癌类型、骨转移灶占全身骨骼放射性总计数的百分率 ,而治疗剂量、骨转移数目、性别、年龄等对疗效的影响不显著。结论　原发癌为前列腺癌与乳腺癌骨转移者、疼痛主要以腰痛或腰痛伴其他部位疼痛者及T/NT为 1 .2～ 2 .0者 ,行15 3 Sm EDTMP治疗疗效更佳。Objective To seek for correlative influencing factors of ~ 153Sm-EDTMP as a palliative treatment for painful skeletal metastases hoping to direct the treatment with ~ 153Sm-EDTMP. Methods Seventy-six patients with painful bone metastases from various primaries were treated with ~ 153Sm-EDTMP. The effects were analyzed and proof-tested according to the grouping separately by kinds of primary cancers, the prime site of pain, radioactivity ratio between skeletal metastases and normal skeletal tissues (T/NT), sum of skeletal metastases, radioactive counts of skeletal metastases and area of skeletal metastases. Multi-factorial regression analysis was made between the effects and the factors. The factors included the above mentioned six factors and other three factors (sex, age and dose of ~ 153Sm-EDTMP). Results 69.74% of patients treated with ~ 153Sm-EDTMP had a positive response. The response in the group of prostate and breast cancers was better than in the group of lung cancers. The difference was significant (P<0.01). The response in the group of patients with lumbago was significantly better than in the group of patients with thigh pain (P<0.01). The response in the group of patients with T/NT=1.21～2.00 was also significantly better than in the group of patients with T/NT=1.00～1.20(P<0.01). The multi-factorial regression analysis showed that the site of pain and the kind of primary cancers and radioactive counts of skeletal metastases were the factors significantly influencing the efficacy; however, the efficacy was not influenced by the dose of ~ 153Sm-EDTMP, sex, age, sum of skeletal metastases. Conclusion The palliative treatment with ~ 153Sm-EDTMP had a better effect in the patients with prostate, breast cancer, lumbago or lumbago accompanied with other site's pain, or T/NT=1.21～2.00.

关 键 词：^153SM-EDTMP 治疗 影响因素 骨肿瘤 肿瘤转移 放射疗法 EDTMP 统计学 

分 类 号：R730.55[医药卫生—肿瘤]