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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。
OBJECTIVE: To determine the bone uptake rate of 153Sm EDTMP (ethylenediamine tetramethylene phosphonic acid) by the whole body imaging system for the first time in China and to explore the relationship between the rate of bone uptake and the curative effect. Methods Sixty-six patients with metastatic bone cancer and pain, 32 males and 34 females, aged from 34 to 71 years (mean 54 years). No chemotherapy or radiotherapy was performed during the 153Sm EDTMP treatment. Whole body imaging was performed at 10 and 5 hours after injection of 153Sm EDTMP using an Elscint dual-probe gamma camera and the rate of bone uptake was determined. Results The bone uptake rate measured by whole body imaging in 66 patients ranged from 31 9% to 86 6% with an average of 56 0%. The bone uptake rates of effective group (57 cases, 25%) were 52.4% ~ 86.6% and 68.77% respectively, and those in effective group (24.4%, 36.4%) were 4 3 7% -70 4% and 5 8 3 ± 7 7 respectively. The bone uptake rates of stable or ineffective group (25 cases, 37 9%) were 31 9% -51 5% and 41 0 ± 6 2, respectively. Statistical analysis showed that there was also a significant difference in the rate of bone uptake between the effective group and the effective group (t = 4258, P = 0 0 01) (t = 8 48 , P = 0 0 0 1). Conclusion The 153Sm EDTMP bone uptake rate was determined by the whole body imaging system in China for the first time and the safe and effective dosage of 153Sm EDTMP was prospectively calculated. The relationship between the bone uptake rate and the curative effect was also observed. 153Sm EDTMP bone uptake Patients with high rates have a better overall response than patients with low rates of bone uptake.