核医学教学课件：Treatment of painful bone metastases with radiopharmaceutical.ppt

Treatment of painful bone metastases with radiopharmaceutical DescriptionBone metastases occur in more than 50% of cancer patients. Up to 80% of breast,prostate and lung cancer patients will develop skeletal metastases. Bone metastases are a very common and often painful problem experienced by many cancer patients. Radiopharmaceutical Therapy for Palliation of Bone Pain from Osseous Metastases become more popular. Goals of treatmentPalliative therapy Palliation of Bone Pain and improve quanity of life Useless to primarily disease123 Principle Radiopharmaceutical analogy with bone constituents localizes in areas of osteoblastic(成骨细胞） activity. The ionising effect of β-radiation lead to DNA damage. Ideal Radiopharmaceutical Most of drugs accumulate in cancer leision ,less of them accumulate in normal bone tissue or it can be quickly clear up.Have a suitable effective half lifeβ-particle energy between 0.5 and 1.0 MeVHave a suitable range of fireAble to emit r-radiation,which can be detect by ECT Indicationhave bone pain or the pain can not relieve even with analgesicSkeletal metastasis involving above 1 site that are positive on bone scan. contraindication Acute or chronic renal and liver failureAcute spinal cord suppressionBone marrow depression Step of therapy Have a bone scan Collect medical history Medication numerical rating scale (NRS) karnofsky performance status scale MedicationTreated in an outpatient setting Patient is instructed about the radiation safety precautionsIntravenous injection Side effectMost patients no reactionFew patients early reaction -Flare reaction (temporary increased pain)， nausea and vomiting，rash… late reaction -temporary bone marrow depression Follow-upBlood counts Blood counts are obtained at least weekly for the first 6 weeks and more frequently if there is evidence of toxicity. Bone scan Retreate Patients whose blood counts do return to pretreatment values may be retreated. Different agent