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目的 分析153 Sm 乙二胺四甲基磷酸 (EDTMP)治疗肺癌多发性骨转移疼痛的疗效及毒副作用。方法 对 1992年至 1998年 115例经病理或细胞学诊断证实的肺癌多发性骨转移疼痛病人做单次或多次153 Sm EDTMP核素止痛治疗。 115例原发灶中 ,腺癌 5 9例 ,小细胞未分化癌 13例 ,鳞癌 18例 ,肺泡细胞癌 2例 ,未分类 2 3例。骨转移灶经骨显像、X线摄片、CT和 (或 )MRI诊断。结果 全组总的治疗有效率为 65 .2 % (其中完全缓解为 19.1% ,部分缓解为 46.1% ) ,无效率为 3 4 .8%。鳞癌骨痛治疗有效率为 72 .2 % ,腺癌为 66.1% ,小细胞肺癌为 61.5 % ,但无显著性差异。未见严重的毒副反应 ,仅有 2 7% ( 3 1/115 )的病人出现不同程度的白细胞、血小板及血红蛋白下降。结论 153 Sm EDTMP静脉注射是肺癌多发性骨转移疼痛的有效治疗手段 ,暂时性、可逆性骨髓抑制是常见的副作用。
Objective To analyze the efficacy and side effects of 153 Sm ethylenediamine tetramethylphosphoric acid (EDTMP) in the treatment of multiple bone metastases of lung cancer. Methods A single or multiple 153 Sm EDTMP nuclide analgesia was performed on 115 patients with multiple bone metastases of lung cancer confirmed by pathology or cytology from 1992 to 1998. 115 cases of primary tumor, adenocarcinoma in 59 cases, 13 cases of small cell undifferentiated carcinoma, squamous cell carcinoma in 18 cases, alveolar cell carcinoma in 2 cases, unclassified 23 cases. Bone metastasis by bone imaging, radiography, CT and / or MRI diagnosis. Results The total effective rate was 65.2% (complete remission was 19.1%, partial remission was 46.1%), the inefficiency was 34.8%. Squamous cell carcinoma treatment of effective rate was 72.2%, adenocarcinoma was 66.1%, small cell lung cancer was 61.5%, but no significant difference. No serious side effects were observed. Only 27% (3 1/115) patients showed different levels of leukocyte, platelet and hemoglobin. Conclusion Intravenous injection of 153 Sm EDTMP is an effective treatment for multiple bone metastases of lung cancer. Temporary and reversible myelosuppression is a common side effect.