89SrCl2与153Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

目的 对比研究89SrCl2和153Sm-乙二胺四亚甲基膦酸(153Sm-EDTMP)治疗骨转移癌疗效.方法 120例骨转移患者随机分为89SrCl2治疗组和153Sm-EDTMP治疗组,分别为69例和51例,89SrCl2剂量为1.11～2.22 MBq/Kg,153Sm-EDTMP剂量为25.9～37.0 MBq/kg,3～6月复查SPECT,对止痛效果、转移灶变化及不良反应进行比较分析.结果 89SrCl2组总有效率、显效、有效、无效分别为92.8%、69.6%、23.3%、7.2%;153Sm-EDTMP组的总有效率、显效、有效、无效分别为94.2%、66.7%、27.5%、5.8%,两组比较的差异无统计学意义(X2=4.98,P>0.05);89SrCl2治疗组骨转移病灶Ⅰ级(变淡,缩小或消失,无新增病灶出现)为56.5%,153Sm-EDTMP组为54.9%,两组比较的差异无统计学意义(X2=4.81,P>0.05);骨髓抑制情况(白细胞和血小板中任一项降低)分别为40.8%和59.2%,两组比较的差异有统计学意义(X2=7.45,P<0.05).结论 153Sm-EDTMP和89SrCl2控制乳腺癌、前列腺癌及大多数肺癌骨转移疼痛有效,可根据经济条件选择相应药物.89SrCl2疗效持久,相对骨髓抑制较小,更安全可靠,可作为早期骨转移患者的首选药物.

Comparison of treatment with 89SrCl2 and 153Sm-ethylenediaminetetramethylene phosphate in metastatic cancers of bone

Objective To evaluate the effect of 89SrCl2 and 153Sm-ethylenediaminetetramethylene phosphonate (153Sm-EDTMP) on metastatic carcinoma of bone. Methods All patients with widespread metastatic bone cancers were divided into two groups randomly: sixty-nine patients were treated with 89SrCl2 with dose of 1.11～2.22 MBq/kg by intravenous injection, fifth-one patients were treated with 153Sm-EDTMP with dose of 25.9～37.0 MBq/kg by the same way. Bone imaging was analized in 3～6 months. The pain, the metastasis varied situation, and side-effect were compared. Results In the group of 89SrCl2 the remission rats of bone pain of positive response, total-effect, apparent, finess, no-effect was 92.8%, 69.6%, 23.3%, 7.2% respectively. In the group of 153Sm-EDTMP, the data were 94.2%, 66.7%, 27.5%, 5.8% respectively. There were not significantly different between groups of 89SrCl2 and 153Sm-EDTMP (X2=4.98, P>0. 05). In group of 89SrCl2 the rate of area of skeletal metastases Grade Ⅰ (disappear, reduction, maintain and no-new-development) was 56.5%. However it was, in 153Sm-EDTMP group, 54.9%. There was no significantly difference between 89SrCl2 and 153Sm-EDTMP groups (X2=4.81, P>0.05). The arrest rate of bone marrow (white blood or blood platelet was descended) of 89SrCl2 group was 40.8% while in 153Sm-EDTMP group was 59.2%. There was a significantly different between them (X2=7.45, P<0.05). Conclusion 89SrCl2 and 153Sm-EDTMP have effect on metastatic carcinoma of bone treatment. It is suggested that one can choose each of them by economic condition. But, 89SrCl2 can maintain the effect in a long time and bone marrow is arrested serious, so it is the first choise for early metastatic carcinoma of bone.