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目的 探讨153钐 乙二胺四亚甲基磷酸 ( 153Sm EDTMP)联合内分泌疗法治疗疼痛性前列腺癌骨转移的疗效。方法 2 7例疼痛性前列腺癌骨转移病人 ,随机分为治疗组 14例 ,用153Sm EDTMP加内分泌疗法联合治疗 ,每次剂量范围为 1110～ 1480MBq ,每人 3～ 4次。对照组单纯用内分泌治疗。治疗后 3个月行骨扫描检查 ,了解转移灶情况。结果 治疗组与对照组骨痛缓解率分别为 92 .9% ( 13 /14)和 76.9% ( 10 /13 ) ;骨痛开始缓解时间中位数分别为 4天和 8天。虽然治疗组骨痛缓解率与对照组比较 ,无显著性差异 (P <0 .0 5 ) ,但前者骨痛开始缓解时间明显早于后者 (P <0 .0 1)。另外 ,治疗组与对照组骨病灶客观反应率分别为 85 .7% ( 12 /14)和 46.2 % ( 6/13 ) ,也有显著性差异 (P <0 .0 5 )。结论 153Sm EDTMP和内分泌疗法联合应用不仅能迅速有效地缓解前列腺癌骨转移疼痛 ,而且可破坏骨肿瘤本身 ,使转移灶缩小或消退 ,其疗效明显优于单纯内分泌治疗
Objective To investigate the curative effect of 153 SMM (153Sm EDTMP) combined with endocrine therapy on bone metastasis of painful prostate cancer. Methods Twenty-seven patients with painful prostate cancer with bone metastases were randomly divided into treatment group (n = 14) and treatment group (153Sm EDTMP plus endocrine therapy). Each dose ranged from 1110 to 1480MBq, 3 to 4 times per patient. Control group with endocrine therapy alone. 3 months after treatment, bone scan examination to understand the situation of metastases. Results The pain relief rates of the treatment group and the control group were 92.9% (13/14) and 76.9% (10/13), respectively. The median pain relief time was 4 days and 8 days respectively. Although the treatment group pain relief rate compared with the control group, no significant difference (P <0.05), but the former onset of pain relief was significantly earlier than the latter (P <0.01). In addition, the objective response rates of bone lesions in treatment group and control group were 85.7% (12/14) and 46.2% (6/13), respectively, with significant differences (P <0.05). Conclusion 153Sm EDTMP combined with endocrine therapy can not only quickly and effectively relieve the pain of bone metastasis of prostate cancer, but also can destroy the bone tumor itself and make the metastasis shrink or disappear, and the curative effect is better than that of endocrine therapy alone