~(89)Sr治疗前列腺癌骨转移疗效分析

目的:评价89Sr治疗前列腺癌骨转移的临床疗效。方法:对确认前列腺癌骨转移伴骨痛的116例患者,行双侧睾丸切除术+内分泌药物+89Sr治疗。89Sr治疗静脉给药,剂量1.48～2.22MBq(40～60μCi)/kg。随访分析临床疗效。结果:①33.6%的患者食欲明显改善,56.0%的患者睡眠明显改善,61.2%的患者止痛药用量显著减少;②骨转移性疼痛缓解总有效率为83.6%,24.1%的患者完全缓解;③骨痛缓解开始出现时间3～21d,平均10.2d;④骨痛缓解维持时间3～12个月,平均5.3个月;⑤31.9%的患者出现"闪烁"痛;⑥生活质量(KPS评分)平均升高20.0%;⑦治疗后18.1%的患者血液白细胞由正常水平下降至3.0～3.9×106/L(Ⅰ度血液毒性反应);⑧随访53例骨显像,治疗后73.6%(39例)骨转移灶数目较治疗前明显减少,18.9%(10例)稳定,7.5%(4例)恶化。结论:89Sr治疗能有效抑制骨转移,缓解骨痛,改善生存质量,不良反应轻,是前列腺癌骨转移性疼痛较理想的治疗方法。

Strontium-89:A Desirable Therapeutic for Bone Metastases of Prostate Cancer

Objective： To evaluate the efficacy of strontium-89 （ 89 Sr） in the treatment of painful bone metastases of prostate cancer. Methods： A total of 116 patients with painful bone metastases of prostate cancer received bilateral orchectomy and incretion, followed by intravenous injection of ^89Sr at the dose of 1.48-2.22 MBq （40-60uCi）/kg. The clinical effects were evaluated by follow-up analysis. Results ： After the 89 Sr treatment, appetite and sleep were evidently improved in 33.6% and 56.0% of the patients respectively, the applied dose of anodyne reduced in 61.2% , pain alleviated in 83.6% , with an absolute palliation rate of 24.1%. Pain relief started at 3-21 （ 10.2 -＋6.5） days and lasted 3-12 （5.3 ±2.2） months. Flare ache occurred in 31.9% of the patients. Compared with pre-treatment, the mean score on Kamofsky＇s performance status （KPS） was 20.0% higher, and the WBC count decreased to 3.0-3.9×10^6/L in 18.1% of the patients. Whole body bone seintigrapby of 53 followed-up patients showed that 39 （73.6%） of them exhibited an obvious decrease in the number of metastases, 10 （ 18.9% ） remained in a stabilized state and only 4 （7.5%） deteriorated. Conclusion： ^89Sr, capable of inhibiting bone metastasis, palliating pain and improving the quality of life with few adverse effects, can be used as a desirable therapeutic for painful bone metastases of prostate cancer.