153 Sm-EDTMP联合“云克”治疗多发性骨转移瘤效果观察.doc

153 Sm-EDTMP联合“云克”治疗多发性骨转移瘤效果观察 　【摘要】 目的 比较单独使用153Sm-EDTMP与153Sm-EDTMP联合“云克”（99Tc-MDP）两种方法治疗多发性骨转移瘤的止痛效果及转移灶效果。方法 96例确诊为多发性骨转移肿瘤中，60例单独使用153Sm-EDTMP治疗，36例使用153Sm-EDTMP联合“云克”治疗，比较两种方法的治疗效果。结果 单独使用153Sm-EDTMP治疗，缓解骨痛的总有效率为61.67%，转移灶消除或缩小的总有效率为20.00%，而153Sm-EDTMP与“云克”联合治疗则分别为88.89%和44.44%，两组间比较差异有高度显著性（P均lt;0.01）。结论 单独使用153Sm-EDTMP治疗和153Sm-EDTMP联合“云克”治疗多发性骨转移瘤都是有效的止痛方法，但153Sm-EDTMP联合“云克”对于多发性骨转移瘤止痛效果更佳（88.89%），同时使部分转移灶完全消失、缩小或减少。 【关键词】 癌；骨转移瘤；153Sm-EDTMP；云克 　　Abstract: Objective To outline the analgesic effects and clinical metastatic effects of 153 Sm-EDTMP vs. 153 Sm-EDTMP in combination with 99 Tc-MDP for treatment of multiple bone metastatic neoplasms. Methods 96 patients proven with multiple bone metastatic tumors were involved in this study. 60 patients were given 153 Sm-EDTMP alone, 36 patients received 153 Sm-EDTMP in combination with 99 Tc-MDP. To compare the clinical outcomes between these two groups. Results In patients treated tumors using 153 Sm-EDTMP alone, the total ostealgia remission rate was 61.67%, the total response rates of metastatic foci eliminating or shrinking was 20.00%; while in patients treated tumors using 153 Sm-EDTMP in combination with 99 Tc-MDP, they were 88.89% and 44.44%, respectively. To compare between these two groups, there were statistically significant differences (Plt;0.01). Conclusion Both 153 Sm-EDTMP alone and 153 Sm-EDTMP in combination with 99 Tc-MDP are effective for analgesia in treatment of multiple metastatic neoplasms, but 153 Sm-EDTMP in combination with 99 Tc-MDP is superior to 153 Sm-EDTMP alone, the former can be more effective and can make some of the metastatic foci eliminate completely, shrink or lessen. 　　Key words: carcinoma; bone metastatic neoplasm; 153 Sm-EDTMP;99Tc-MDP 　　恶性肿瘤如肺癌、乳腺癌及前列腺癌等常伴发骨转移，多数患者有持续日益加重的骨痛，严重影响其生活质量及寿命。传统治疗多用麻醉剂、激素或化疗止痛，效果不佳，外照射放疗虽有明显镇痛作用，但对多发性病灶却无能为力。2003年5月～2007年2月我们应用153Sm-EDTMP与“云克”（99Tc-MDP）联合治疗多发性骨转移瘤，取得较好效果，现报道如下。 　　1 资料与方法 　　1.1 一般资料 153Sm-EDTMP治疗组：60例，其中男35例，女25例，平均48岁。其原发灶