153Sm-EDTMP治疗转移癌性骨痛

目的 探讨影响^153Sm-乙二胺四亚甲基磷酸盐（EDTMP）治疗转移癌性骨痛疗效的相关因素。方法 按国际原子能机构区域合作计划组织中国多中心研究，3年内收集^153Sm-EDTMP治疗转移癌性骨痛234例，根据治疗响应分为有效及无效2组，比较其个人情况，临床特点，原发病种，骨转移特点及治疗方法等因素，以SAS软件进行分组与多因素分析。结果 183例治疗有效，51例治疗无效，2组间在年龄、非核素治疗、^153Sm-EDTMP用量、转移灶数目、占骨骼比重、放射性摄取程度等方面无明显差别。但无效组中男性（43例，84.3%）、肺癌（34例，66.7%）、脊柱、骨盆与下肢转移的比例明显不同于有效组。多因素分析证实患者性别、肿瘤类型和转移部位与治疗效果相关。结论 ^153Sm-EDTMP治疗对肺癌、男性和下半身转移者效果可能较差。

Comparative analysis on therapeutic response related factors to 153Sm-EDTMP palliation for painful skeletal metastases

Objective To comparatively analyze the factors related to the therapeutic response in the patients with painful bone metastases who failed to respond to 153 Sm ethylene diamine tetramethylene phosphonic acid (EDTMP) palliation. Methods 234 cases were collected in a multicenter trial organized by IAEA using a single dose of 153 Sm EDTMP to treat painful skeletal metastases. The types of the primaries, general condition of the patients, characteristics of metastases, etc. were analyzed using SAS software. Results No positive relationship could be confirmed between therapeutic response and the parameters like patients' age, previous treatment, general condition, extent of bony involvement, and dose of therapeutic agent. Tumor type(i.e. lung cancer), sex(male), and location of metastatic foci of the patient were the factors noted to relate to response. Conclusion Although the underlined mechanism is not fully understood, sufferers of lung cancer, especially male patients with metastases to lower part of skeleton, are at higher risk of not responding to 153 Sm EDTMP palliation.