Asian Journal of Nuclear Medicine

Volume 1 Number 1, April 2001


復旦大學醫學院附屬中山醫院核醫學科,上海 200032,中國。

目的 比較153Sm-EDTMP和153Sm-EDTMP聯合"雲克"兩種治療方法,對多發性骨轉移癌止痛的療效。方法 97例臨床證實為多發性骨轉移患者中38例單獨用153Sm-EDTMP治療,59例用153Sm-EDTMP聯合"雲克"治療。153Sm-EDTMP治療每次劑量32MBq/kg,聯合"雲克"(Tc-MDP)於153Sm-EDTMP治療前或治療後第五天開始用藥,200mg"雲克"加在250ml生理鹽水中靜脈緩滴。兩組都在153Sm治療後2-3天,用99mTc-MDP按常規全身骨掃描採集條件進行全身採集。結果 單純用153Sm-EDTMP疼痛緩解23例,總有效率60.5%;聯合"雲克"治療51例患者疼痛緩解,總有效率為 86.4%。兩組療效有明顯的統計學意義(p<0.001)。骨掃描顯示有99mTc-MDP濃聚部位也有153Sm-EDTMP的濃聚。結論153Sm-EDTMP單獨或153Sm-EDTMP聯合"雲克"治療骨轉移癌都是行之有效的止痛方法,對骨髓抑制作用較低,副作用較少,但 153Sm-EDTMP聯合"雲克"對多發性骨轉移癌止痛效果更具有優越性。

【關鍵字】 153Sm-EDTMP;雲克;骨轉移癌

The Effects of 153Sm-EDTMP combination of Tc-MDP for palliation of metastatic bone pain

GU Xiaoyun, CHEN Shaoliang, CHEN Kejing, et al. Department of Nuclear Medicine of Zhongshan Hospital, Fudan University Medical College, Shanghai 200032,.China.

Objective The aim of this study was to compare the palliation of metastatic bone disease pain by the administration of the ethylenediaminetetramethylenephosphonic acid chelated with the radionuclide 153Sm (153Sm-EDTMP) with 153Sm-EDTMPcombination of 99Tc-MDP. Methods In this study, all the ninety-seven patients were classified into two groups: group A: 153Sm-EDTMP was injected intravenously into thirty-eight patients; group B: 5 days before or after the injection of 153Sm-EDTMP, 99Tc-MDP (200mg) dissolved in normal saline (500ml) was infused into fifty-nine patients over a 2-hour period. All the patients received up 153Sm-EDTMP from 1 to 5 injections of 32 MBq per kilogram of body weight according to the extent of disease and stage. 2 or 3 days after the administration of 153Sm-EDTMP, all the patients were underwent bone scanning with Tc-99m-MDP. Results Pain relief often occurred in approximately 1-2 days and lasted 16-20 days. Group A, response was 60.5%; fifty-one patients (84.4%) reported significant pain relieves in group B, and the response was significantly higher than that of group A (X2, p<0.001). Conclusions Systemic radionuclide therapy using 153Sm-EDTMP or 153Sm-EDTMP combination of Tc-MDP is a feasible and effective palliative treatment in metastatic bone patients with limited red marrow doses and no toxic effects in other organs, but the method of 153Sm-EDTMP combination with 99Tc-MDP may assess more significant response. (Asian J Nucl Med 2001;1:35-36)

Key Words : 153Sm-EDTMP; Tc-MDP; Bone metastases

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