核素骨显像在多发性骨髓瘤疗效评价中的应用

来源 :中德临床肿瘤学杂志 | 被引量 : 0次 | 上传用户:shepuqi4709
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Objective: To investigate the value of radionuclide whole-body bone imaging on monitoring chemotherapeutic effects for multiple myeloma (MM). Methods: Sixty patients were included. Twenty nine cases received CTD (thalidomide 100-200 mg/d; cyclophosphamide 200-300 mg/m2·d, 1-4 days, every 4 weeks; and dexamethasone 20-40 rag/d, 1-4 days, every 4 weeks); Thirty cases received VAD (vincristine 0.4 mg/d, 1-4 days, every 4 weeks; adriamycin 10 rag/d, 1-4 days, ev-ery 4 weeks; dexamethasone 40 mg/d, 1-4 days, every 4 weeks). Radionuclide bone imagings were performed in all patients before chemotherapy, six months, twelve months and eighteen months after chemotherapy. The correlation of chemotherapeutic effects between CTD and VAD were analyzed. Results: One hundred and seventy nine bone lesions were visualized by bone scintigraphy before CTD treatment. Eighteen months after CTD chemotherapy, it was observed by bone scintigraphy that 39/179 (21.78%) lesions disappeared, 112/179 (62.57%)improved, and 28/179 (15.64%) had no change. One hundred and ninety one bone lesions were showed by bone imaging before VAD treatment, 36/191 (18.84%) lesions disappeared, eighteen months after chemotherapy, 103/191 (53.92%) improved, and 52/191 (27.22%) had no change. The significant difference was observed in locations of MM induced bone lesions treated with CTD (H = 8.23, P < 0.05) and VAD (H = 11.18, P < 0.05). A significant chemotherapeutic sensitivity in detecting MM induced lesions in ribs was found compared with other bone lesions. The chemotherapeutic effect of CTD was statistically significant than that of VAD (U = 2.17, P < 0.05). Conclusion: Radionuclide whole-body bone imaging has great value in monitoring chemotherapeutic effects for MM.
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