^(188)Re-CL58、^(131)I-chTNT放射免疫治疗的临床研究  

Clinical Study on Radioimmunotherapy of Tumor with Multiple Low-dose ^(188) Re-CL58and High Dose ^(131) I-chTNT

作　　者：丁勇[1] 田嘉禾[1] 杨武威[2] 杨志 徐发良[2] 张书文[1] 陈英茂[1] 关志伟[1] 

机构地区：[1]解放军总医院核医学科,北京市100853 [2]军事医学科学院附属医院 [3]北京大学肿瘤医院核医学科

出　　处：《中国肿瘤临床》2004年第1期8-11,共4页Chinese Journal of Clinical Oncology

基　　金：全军九五攻关项目基金资助(编号:96M135)

摘　　要：目的:比较多次小剂量与大剂量放射免疫治疗(RIT)对实体瘤的初步临床疗效及不良反应。方法:采用多次小剂量188Re-CL58及大剂量131I-chTNT对临床病例治疗。用脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)显像方法及动态观察血清中肿瘤标志物变化监测疗效。用间接免疫荧光法评价RIT对T淋巴细胞亚群的影响。观察其对造血系统和肝、肾等器官的不良反应。结果:多次小剂量188Re-CL58治疗后病灶部位的FDG摄取SUV值(Standarduptakevalue)均下降,对于小转移灶SUV下降更明显,且血清CEA等水平均下降,而大剂量131I-chTNT组CEA下降不及多次小剂量组明显。多次小剂量RIT后外周血CD4+细胞升高、CD8+细胞减少以及CD4+/CD8+比例升高,而大剂量RIT后CD4+/CD8+比例降低。大剂量组比多次小剂量组对白细胞、血小板、血色素的抑制明显,结论:多次小剂量188Re-CL58治疗效果优于大剂量131I-chTNT,且能解除肌体的免疫抑制;多次小剂量188Re-CL58治疗对造血系统抑制小于大剂量131I-chTNT。Objective:To compare the efficiency and toxication of multiple low-dose(MLD) 188 Re-CL58and high dose(HD) 131 I-chTNT on treatment of cancer.Methods:Patients were treated with MLD of 188 Re-CL58(or 131 I-Hab18)or HD of 131 I-chTNT.The corresponding efficien-cies and toxications were compared.Results:After treatment with MLD-RIT and HD-RIT,FDG accumulation in lesions was decreased significantly.In some cases,SUV of the micro-metastases were even brought down to the normal line.After treatment with RIT,tumor markers such as CEA also decreased in varying degree,with MLD 188 Re-CL58more efficient than HD 131 I-chTNT.MLD 188 Re-CL58affected the immune system positively for it brought down CD 3+ cell and brought up the ratio of CD 4+ /CD 8+ .MLD RIT induced no visible blood toxication.Both of them had no toxic effect on liver and kidney.Conclusions:MLD RIT were efficient for the treatment of mi -cro-metastasis.MLD RIT partially relief the immune system from suppression,The toxication of RIT was manifested mainly as blood cell inhibition.

关 键 词：正电子发射断层扫描 单克隆抗体 肿瘤 放射免疫治疗 

分 类 号：R730.5[医药卫生—肿瘤]