^(89)SrCl_2对老年人前列腺癌转移性骨痛的疗效观察  

The evaluation of palliative effect of ^(89)SrCl_2 in elderly patients with prostate cancer and metastatic bone-pain

作　　者：陈雪红[1] 钟甘平[2] 王正江[1] 袁耿彪[1] 王家吉[2] 冯建中[1] 李西焕[1] 

机构地区：[1]兰州医学院第二附属医院核医学科,730030 [2]兰州医学院第二附属医院泌尿外科,730030

出　　处：《中华老年医学杂志》2003年第12期720-722,共3页Chinese Journal of Geriatrics

摘　　要：目的　评价89SrCl2 对老年人前列腺癌转移性骨痛的临床疗效。　方法　对 2 9例老年前列腺癌骨转移伴骨痛患者静脉注射放射性核素89SrCl2 ,每次 1 4 8～ 2 2 2MBq kg ,重复使用在首次用药后 3～ 6个月 ,治疗 2个疗程 ,观察其疗效。　结果　治疗后骨痛减轻或消失 2 4例 ,总有效率为82 8% ;骨痛缓解可维持 3～ 6个月。治疗后 3个月做骨显像有 16例 (5 5 2 % )骨转移灶代谢减低 ,对治疗前、后骨显像感兴趣区 (ROI)比值 (治疗前为 5 4 0± 3 2 3,治疗后为 3 0 6± 1 79)进行比较 ,差异有显著性 (P <0 0 5 )。治疗前 17例 (5 8 6 % )前列腺特异抗原 (PSA)≥ 2 0 μg L ,治疗后 3个月复查仅有 4例 (13 8% )≥ 2 0 μg L ,PSA在异常范围的患者所占百分率明显下降。治疗后有 6例(2 0 7% )出现Ⅰ～Ⅱ度血液学毒性反应 ,但对肝肾功能无影响。　结论　89SrCl2 对缓解老年前列腺癌患者骨转移癌疼痛有较好的疗效 ,副作用小 ,可以重复使用。Objective To evaluate the palliative effect of 89 SrCl_2 on bone metastasis of prostate cancer accompanied with bone-pain. Methods Twenty-nine elderly patiens with prostate cancer accompanied with bone metastasis had been treated by venous injection of 89 SrCl_2 at a dose of 1.48-2.22 MBq/kg and injected again after 3-6 months. The patients were treated for 2 courses and the outcome was evaluated. Results The bone-pain vanished or palliated in 24 cases after therapy with remission lasting 3-6 months. The effective rate was 82.8%. The metabolism of metastatic cancer nests was decreased in 16 cases (55.2%) 3 months after treatment. Comparison of ROIs(region of interests) count in the metastatic lesions pre-treatment to ROIs counts post-treatment in these patients showed significance(5.40±3.23 vs 3.06±1.79, P <0.05). PSA≥20μg/L was observed in 17 cases(58.6%) before treatment while PSA≥20μg/L was observed in only 4 cases(13.8%) three months after the treatment, showing that the percentage of patients with abnormal PSA was decreased significantly. I-II degree hematology toxic reaction was seen in 6 cases(20.7%). The damage of liver and kidney was not observed. Conclusions The 89 SrCl_2 is effective on elder prostatic cancer patients with bone metastasis and bone pain, and the side effects are mild. The drug can be used repeatedly.

关 键 词：老年人 锶放射性同位素 前列腺肿瘤 骨肿瘤 ^89SRCL2 

分 类 号：R737.25[医药卫生—肿瘤]