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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。
OBJECTIVE: To evaluate the clinical efficacy of 89Sr in the treatment of bone metastases from prostate cancer. Methods: One hundred and sixty-six patients with bone metastasis and bone pain confirmed by prostate cancer underwent bilateral orchiectomy + endocrine therapy with 89Sr. 89Sr intravenous administration, the dose of 1.48 ~ 2.22MBq (40 ~ 60μCi) / kg. Follow-up analysis of clinical efficacy. Results: (1) The appetite was significantly improved in 33.6% of the patients, the sleep was significantly improved in 56.0% of the patients and the dosage of painkillers was significantly decreased in 61.2% of the patients. The total effective rate of bone metastatic pain relief was 83.6% and 24.1% ; ③ the onset of pain relief began 3 ~ 21d, an average of 10.2d; ④ pain relief to maintain the time of 3 to 12 months, an average of 5.3 months; ⑤ 31.9% of patients with “flashes” pain; ⑥ quality of life (KPS score) increased by 20.0% on average. (7) After treatment, 18.1% of patients’ blood leukocyte decreased from normal level to 3.0-3.9 × 106 / L (Ⅰ degree of hematologic toxicity); ⑧ 53 cases were followed up for bone imaging, 73.6 In the 39 cases, the number of bone metastases was significantly lower than that before treatment, 18.9% (10 cases) stabilized and 7.5% (4 cases) deteriorated. Conclusion: 89Sr can effectively inhibit bone metastasis, relieve bone pain, improve quality of life, and have mild adverse reactions. It is an ideal treatment for bone metastases of prostate cancer.