153Sm-EDTMP治疗多发骨转移瘤的剂量效应关系初步观察

Objective： To calculate the focus absorption dose of ^153Sm-EDTMP with the Monte Carlo （MC） EGS4 method for treatment of bone metastases from nasopharyngeal carcinoma or breast cancer, and investigate the relationship between the focus absorption dose and painkilling effect of ^153Sm-EDTMP. Methods： Four patients with multiple bone metastases from nasopharyngeal or breast carcinoma and suffered from grade IV bone pain were treated with radionuclide internal irradiation of ^153Sm-EDTMP. The absorption dose and dose distribution of bone metastases and other targeted organs were calculated with MC EGS4 program based on the time-order SPECT/CT scanning and the measurement of the radioactivity in the urine accumulation. The release of bone pain and the improvement of life quality were observed. Results： Bone pain of the patients was significantly alleviated to grade II for 3-4 weeks after internal ^153Sm-EDTMP irradiation. The 3-dimensional absorption dose distribution image of bone metastases and targeted organs showed that the dose distribution in bone metastases was not asymmetrical. After injection of 0.65 × 37 MBq/kg ^153Sm-EDTMP, the highest absorption dose in bone lesions was about 4.9-5.9 Gy, and the dose in the lesion margin was about 2.0 Gy. Using the highest dose as reference dose point, the relative absorption dose values of bone marrow, vertebra and sex organ near lesions were 0.48-1.1 Gy, 0.51-0.85 Gy, and 0.01-0.14 Gy, respectively. Conclusion： The absorption dose of bone metastases is significantly lower than treatment dose of 30 Gy after single irradiation of ^153Sm-EDTMP. The painkilling effect is limited and in accordance with clinical observation.