153Sm-EDTMP治疗恶性肿瘤骨转移的临床价值

目的评价放射性核素153钐-乙二胺四甲撑酸(153Sm-EDTMP)治疗恶性肿瘤骨转移的疗效和副作用;方法用153Sm-EDTMP对186例骨转移的病人进行内照射治疗,剂量(29.6～37.0)MBq/kg体重,观察治疗前后骨痛、血清碱性磷酸酶(ALP)、血细胞及病灶的变化;结果186例病人中154例(82.8%)骨痛缓解,随访25例病人有8例(36.3%)病人骨转移灶钙化或消除;治疗后病人末梢白细胞、血小板、红细胞和血红蛋白较治疗前均有显著降低(t=8.19、7.39、5.00、4.15、P均＜0.001);结论153Sm-EDTMP对转移性骨肿瘤有明显缓解骨痛、控制病情进展和消除病灶的作用,同时有降白细胞、红细胞和血红蛋白的副作用.

IMPLICATION OF TREATMENT OF OSSEOUS METASTASIS OF MALIGNANT TURNORS WITH 153Sm- EDTMP

Objective:To evaluate the effects and side effects of samatium-153-ethy lenediamine tetranethylene phosphonnic acid ( 153 Sm -EDTMP)in the treatment of osseous metastasis of malignant turnors.Methods:186 patients with osseous metastasis under trentment with 153 Sm -EDTMP ranged from 29.6 to 37.0MBq/kg.the changes of bone rain,blood pictures and metstasis foci were observed before and after the treatment.Results:After treatment, 154 of 186 cases (82.8%) experienced osteodynia relief and the calcification and disappearance of metastasis foci were found in 8 of 25 to follow-up patients. The counts of WBC,PLT,RBC and Hb level decreased significantly after treatment comparied with that before treatment (t=8.19?7.39?5.00?4.15 separatly,P<0.001).Conclusion:Treatment of malignant tumor osseous metastasis using 153 Sm -EDTMP has efficiency on osteodyhid relief,metastasis foci control but induces the decreased level of WBC, RBC and Hb.