摘要
OBJECTIVE: To evaluate the measurement of Samarium-153 ethylenediaminetetramethylene phosphonic acid ((153)Sm-EDTMP) bone uptake rate using whole-body scintigraphy and analyze the relationship between bone uptake rate and therapeutic effect. METHODS: Sixty-six patients with painful bony metastases from prostate (n = 15), lung (n = 20), breast (n= 18), nasopharyngeal carcinoma (NPC) (n=5), colon (n=2), kidney (n=2) and unknown cause (n=4) carcinoma were examined with whole-body scintigraphy 10 min and 5 h post administration of (153)Sm-EDTMP. Bone uptake rate was then calculated. (1 ) Complete response (CR): disappearance of > 2 metastases, Karnofsky Performance Score (KPS) increase > 20, moderate or complete remission of bone pain 7 d post injection of (153)Sm-EDTMP. (2) Partial response (PR): disappearance of 1-2 metastases, KPS increase 10-20, moderate remission of bone pain in 3 wk. (3) Non-response (NR): no disappearance or shrinkage of metastases, KPS increase
目的 在国内首次采用全身显像法测定153Sm EDTMP(乙二胺四甲撑膦酸 )骨摄取率并探讨骨摄取率与疗效之间的关系。方法 骨转移癌伴疼痛患者 6 6例 ,男 32 ,女 34,年龄 34～ 71岁 ,平均 5 4岁。在接受153Sm EDTMP治疗期间未进行化疗或放疗。使用Elscint双探头γ相机 ,于注射153Sm EDTMP后 10分和 5小时 ,进行全身显像并测定骨摄取率。结果 6 6例患者全身显像法测定的骨摄取率范围在 31 9%～ 86 6 %之间 ,平均 5 6 0 %。其中显效组 (17例 ,2 5 7% )的骨摄取率为 5 2 4 %～ 86 6 % ,6 8 7± 9 7;有效组 (2 4例 ,36 4 % )的骨摄取率为 4 3 7%～ 70 4 % ,5 8 3±7 7;稳定或无效组 (2 5例 ,37 9% )的骨摄取率为 31 9%～ 5 1 5 % ,4 1 0± 6 2。统计学分析表明 ,显效组与有效组(t=4 2 5 8,P =0 0 0 1)、有效组与稳定或无效组之间的骨摄取率也存在显著性差异 (t=8 4 8,P =0 0 0 1)。结论 在国内首次采用全身显像法测定153Sm EDTMP骨摄取率并前瞻性地计算153Sm EDTMP安全而有效的个体化给药剂量 ;初步观察到骨摄取率与疗效之间的关系 ,即153Sm EDTMP骨摄取率高的患者 ,其总体疗效好于骨摄取率低的患者。
基金
TheprojectissupportedbytheNaturalScienceFoundationofChina(No 2 99710 2 7)
