放射性核素89Sr治疗肺癌骨转移疼痛的临床研究

 目的　探讨晚期肺癌骨转移疼痛的治疗方法，评价放射性核素89Sr对肺癌骨转移疼痛的治疗效果及不良反应。方法　对56例未接受过任何放疗的支气管肺癌骨转移患者，按每次1.48×107 Bq／人标准静脉注射89Sr治疗。随访6个月，根据以下参数评定：疼痛程度及疼痛发作频率，分别赋予量化值并获疼痛评分，疼痛评分的比较采用t检验；根据治疗前后骨显像显示的病灶大小或数目的变化，对病灶疗效进行分级；检测血清癌胚抗原（CEA）和神经元特异烯醇化酶（NSE），其治疗前后变化比较采用t检验；治疗前后白细胞及血小板的变化比较采用t检验。结果　治疗后6个月内，疼痛程度缓解的患者占77 ％（43／56），其中13 例疼痛消失，占23 %。疼痛评分由治疗前（7.3±3.6）分下降至治疗后（5.3±3.4）分，降低明显（t＝2.928，P＜0.05）。治疗后病灶消退14例，缩小或变浅5例，总有效率为34 ％（19／56）。治疗前后CEA由（33.64±18.15）μg／L显著下降至（21.36±11.65）μg／L（t＝4.26，P＜0.01），NSE由（27.16±10.12）μg／L显著下降至（12.56±4.23）μg／L（t＝4.26，P＜0.05）。白细胞及血小板在治疗后1个月降至最低，白细胞降低幅度约27.9 ％，血小板降低约19.7 ％，3个月时血象正常率为75 %（42／56）。结论　放射性核素89Sr治疗肺癌骨转移疼痛效果好、安全、不良反应轻，可以提高患者生活质量。

A clinical study on Strontium-89 palliative therapy in lung cancer patients with bone metastases

Objective To explore the methods of therapy in lung cancer patients with bone metastases, and evaluate the effects and side effects of Strontium-89 palliative therapy in lung cancer patients with bone metastases. Methods About 56 cases of bronchiogenic cancer patients with bone metastases who did not receive any radiotherapy, according to 1.48×10~7 Bq/person/time, using standard intravenous injection ~(89)Sr as treatment. Follow-up 6 months, assess according to the following parameters: pain and frequency of pain were given quantized value and got pain score, using T test for comparing the pain score. According to before and after treatment bone imaging showed the size of focus and change of the number, upgrade focus therapy effect. Examine (CEA) and (NSE), using T test for changes before and after treatment. Using T test for changes of LEU and platelet after treatment. Results After treatment for 6 months, for 77 % patients are alleviating pain (43/56), the pain went off of 13 patents, account for 23 percent of the total. The pain score from 7.3±3.6 before treatment decrease to 5.3±3.4 after treatment, dropping obviously. After treatment, the focus regressed in 14 cases, decreased in 5 cases, total efficiency is 34 %. Before and after treatment, CEA from (33.64±18.15)μg/L obviously decreased to (t=4.26, P<0.01) to (21.36±11.65) μg/L, NSE from (27.16±10.12) μg/L obviously decreased to (t=4.26, P<0.05) to (12.56±4.23) μg/L. After treatment, LEU and platelet decreased to the lowest, LEU decreased about 27.9 %, platelet decreased about 19.7 %, after 3 months,normal rate of blood picture is 75 %(42/56). Conclusion The method of strontium-89 palliative therapy in lung cancer patients with bone metastases is good, safe and has little side effects, it can improve the quality of patients life.