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骨转移瘤最常见于晚期恶性肿瘤,包括肺癌、乳腺癌、前列腺癌(prostate cancer,PCa)、结直肠癌、甲状腺癌等[1]。骨转移瘤严重影响患者的生活质量,尤其是其引起的顽固性骨痛、病理性骨折、脊髓受压和高钙血症等骨相关事件(skeletal-related events,SRE)。
目前临床治疗骨转移瘤的常用方法包括手术、放化疗、激素治疗、中药治疗等[2]。但骨转移瘤并发症的发生率和病死率依旧较高,其中胃癌、肝癌、结直肠癌和肺癌患者发生骨转移后的总生存期(overall survival time,OS)均<6个月[3]。因此,骨转移瘤的早期诊断与有效治疗对提高患者生活质量和改善预后至关重要。随着基础医学与临床研究的发展,骨转移瘤的诊断方法和治疗策略也在不断更新和改进。近年来,放射性药物靶向治疗成为骨转移瘤的重要治疗方法之一。
α粒子放射性药物在骨转移瘤治疗中的应用进展
Application and progress of α-particle radiopharmaceuticals in the treatment of bone metastases
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摘要: 骨骼是晚期恶性肿瘤的常见转移部位之一,骨转移瘤不仅会导致顽固性骨痛、病理性骨折等骨相关事件(SRE)的发生,还会导致医疗费用的增加和死亡风险的上升。放射性药物内放射治疗具有疗效好、靶向性好和毒性低等优点。常用于治疗骨转移瘤的放射性药物主要是释放β粒子和α粒子的药物,其中释放β粒子的放射性药物的临床应用较成熟,但也具有一定的局限性。近年来,释放α粒子的放射性药物越来越多地用于骨转移瘤的治疗,其在缓解骨痛、降低SRE发生率、延长总生存期等方面具有更大的优势。笔者仅就α粒子放射性药物在骨转移瘤治疗中的应用进展进行综述。Abstract: Bone is one of the common metastatic sites of advanced malignant tumors. Bone metastases not only lead to bone-related events (SRE), such as intractable bone pain and pathological fractures, but also result in the increase of medical costs and the risk of death. Internal radiotherapy with radiopharmaceuticals has the advantages of good curative effect, good targeting, and low toxicity. The radiopharmaceuticals commonly used in the treatment of bone metastases are those that release β-particles and α-particles. The clinical application of radiopharmaceuticals releasing β-particles is mature but has some limitations. In recent years, radiopharmaceuticals releasing α-particles are increasingly used in the treatment of bone metastases, because they have greater advantages in relieving pain, reducing the incidence of SRE, and prolonging overall survival than radiopharmaceuticals releasing β-particles. In this work, the authors review the progress in the application of α-particle radiopharmaceuticals in the treatment of bone metastases.
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Key words:
- Alpha particles /
- Radiopharmaceuticals /
- Neoplasm metastasis /
- Bone
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