89SrCl2与153Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

何建华; 喻文才

doi:10.3760/cma.j.issn.1673-4114.2009.02.007

⁸⁹SrCl₂与¹⁵³Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

重庆市第二人民医院核医学科, 重庆 402160

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

Department of Nuclear Medicine, the Second People's Hospital of Chongqing, Chongqing 402160, China

摘要: 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(χ²=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(χ²=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(χ²=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.
- 肿瘤转移 /
- 骨肿瘤 /
- 锶放射性同位素 /
- ¹⁵³Sm-乙二胺四亚甲基膦酸
Abstract: 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 (χ²=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 (χ²=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 (χ²=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.
- Neoplasm metastasis /
- Bone neoplasms /
- Strontium radioisotopes /
- ¹⁵³Sm-ethylene diamihe tetramethylene phosphonic acid
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[1]	Tian JH, Zhang JM, Hou QT, et al. Multicentre trial on the efficacy and toxicity of single-dose samarium-153-ethylene diamine tetramethylene phosphonate as a palliative treatment for painful skeletal metastases in China. Eur J Nucl Med, 1999, 26(1):2-7.
[2]	楼岑,张大平,余林良,等.89锶内照射治疗转移性骨肿瘤的临床研究.中华肿瘤杂志,2001,23(6):507-509.
[3]	Baczyk M, Czepczynski R, Milecki P, et al. ⁸⁹Sr versus ¹⁵¹Sm-EDTMP:comparison of treatment efficacy of painful bone metastases in prostate and breast carcinoma. Nucl Med Commun, 2007, 28(4):245-250.
[4]	Liepe K, Kotzerke J. A comparative study of ¹⁸⁸Re-HEDP, ¹⁸⁶Re-HEDP, ¹⁵³Sm-EDTMP and ⁸⁹Sr in the treatment of painful skeletal metastases. Nucl Med Commun, 2007, 28(8):623-630.
[5]	路宇,杨志杰.¹⁵³Sm-EDTMP、⁸⁹SrCl₂治疗前列腺癌、乳腺癌骨转移瘤的对比研究.哈尔滨医科大学学报,2007,41(6):630-631.

[1]	刘康其 , 周海中 . 氯化锶[⁸⁹Sr]治疗转移性骨肿瘤致骨髓抑制的相关因素. 国际放射医学核医学杂志, 2022, 46(4): 254-258. doi: 10.3760/cma.j.cn121381-202101032-00154
[2]	叶慧 , 莫逸 , 谢爱民 , 彭翔 . ¹⁸F-氟脱氧葡萄糖PET-CT与99nTc-亚甲基二膦酸盐骨显像诊断转移性骨肿瘤的对比研究. 国际放射医学核医学杂志, 2008, 32(3): 147-150.
[3]	刘超 , 邓智勇 , 刘鹏杰 , 贾莉 . ⁸⁹SrCL₂与唑来膦酸联合治疗乳腺癌转移性骨肿瘤的疗效分析. 国际放射医学核医学杂志, 2014, 38(5): 300-303. doi: 10.3760/cma.j.issn.1673-4114.2014.05.006
[4]	青春 , 邓候富 , 贾志云 . 放射性核素⁸⁹Sr治疗骨转移癌的新进展. 国际放射医学核医学杂志, 2007, 31(3): 160-162.
[5]	袁超 , 李卫鹏 , 胡永全 , 陶健 . ⁸⁹Sr治疗乳腺癌和前列腺癌多发性骨转移的临床观察. 国际放射医学核医学杂志, 2010, 34(4): 220-222. doi: 10.3760/cma.j.issn.1673-4114.2010.04.008
[6]	袁志斌 . ⁸⁹Sr及联合治疗转移性骨肿瘤的临床应用. 国际放射医学核医学杂志, 2005, 29(2): 53-56.
[7]	郭睿 , 晋建华 , 任媛 , 李思进 , 李险峰 , 张晓娟 . ^99mTc-枸橼酸盐显像鉴别骨转移癌与良性退行性骨病变. 国际放射医学核医学杂志, 2008, 32(3): 162-164.
[8]	张敬勉 , 赵新明 , 王建方 , 戴春暖 , 李德志 , 孙莉 , 江志华 . ⁹⁹Tc-亚甲基二膦酸盐与¹⁵³Sm-乙二胺四亚甲基膦酸对骨侵袭和骨质溶解抑制作用的对比研究. 国际放射医学核医学杂志, 2008, 32(6): 321-325.
[9]	刘康其 , 周海中 . 放射性药物联合双膦酸盐类药物治疗肿瘤骨转移研究现状. 国际放射医学核医学杂志, 2019, 43(2): 166-170. doi: 10.3760/cma.j.issn.1673-4114.2019.02.012
[10]	王俊起 , 高硕 . PET评价骨转移瘤. 国际放射医学核医学杂志, 2006, 30(2): 87-90.

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⁸⁹SrCl₂与¹⁵³Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

重庆市第二人民医院核医学科, 重庆 402160

收稿日期: 2008-10-11

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摘要: 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(χ²=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(χ²=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(χ²=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

Department of Nuclear Medicine, the Second People's Hospital of Chongqing, Chongqing 402160, China

Received Date: 2008-10-11

Abstract: 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 (χ²=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 (χ²=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 (χ²=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.

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⁸⁹SrCl₂与¹⁵³Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

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

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⁸⁹SrCl₂与¹⁵³Sm-乙二胺四亚甲基膦酸治疗骨转移癌的对比研究

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

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