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目的 :评价骨膦和153钐乙二胺四甲撑磷酸 ( 153SmEDTMP)对头颈肿瘤骨转移灶单独及联合应用的效果及毒副作用。方法 :收治头颈肿瘤骨转移病人 61例 ,随机分为骨膦组、153SmEDTMP组和骨膦 +153SmEDTMP组进行对照研究。结果 :骨膦组、153SmEDTMP组和骨膦 +153SmEDTMP组的疼痛缓解率分别为 85 %、82 6%、83 3 % ,三者比较差别无统计学意义。骨膦组及骨膦 +153SmEDTMP组 4例血钙升高者 ,治疗后全部降至正常 ,153SmEDTMP组 2例中 ,1例降至正常。骨膦组、153SmEDTMP组、骨膦 +153SmEDTMP组 ,骨转移病灶的缓解率分别为 :5 %、13 %、3 8 9%。骨膦组病人毒副作用轻微 ,有 2例出现轻度呕吐 ;153SmEDTMP及骨膦 +153SmEDTMP组分别有 8例及 6例出现Ⅰ～Ⅱ骨髓抑制。结论 :骨膦和153SmEDTMP均可有效地治疗骨转移所致的疼痛 ,骨膦可有效地控制肿瘤性高血钙 ,骨膦和153SmEDTMP联合应用可提高骨转移灶的缓解率
Objective : To evaluate the efficacy and toxic side effects of bone phosphine and 153钐 ethylenediamine tetramethyl phosphonate (153SmEDTMP) on bone metastases of head and neck tumors alone and in combination. METHODS: A total of 61 patients with bone metastases from head and neck tumors were randomized and divided into two groups: bone phosphine group, 153SmEDTMP group and bone phosphine +153SmEDTMP group. Results: The pain relief rates in the bone phosphine group, the 153SmEDTMP group, and the bone phosphine +153SmEDTMP group were 85%, 826%, and 83%, respectively. There was no statistically significant difference between the three groups. Four patients with hypercalcemia in the bone phosphine group and the bone phosphine +153SmEDTMP group were all reduced to normal after treatment. In the 153SmEDTMP group, 1 patient was normalized. In the bone phosphine group, the 153SmEDTMP group, and the bone phosphine +153SmEDTMP group, the remission rate of bone metastases was 5%, 13%, and 389%, respectively. Patients in the bone phosphine group had mild side effects, and mild vomiting occurred in 2 patients. I~II bone marrow suppression occurred in 8 patients and 6 patients in the 153SmEDTMP and bone phosphonium +153SmEDTMP groups, respectively. Conclusion : Both bone phosphine and 153SmEDTMP can effectively treat the pain caused by bone metastasis. Phosphide can effectively control tumor hypercalcemia. The combination of bone phosphine and 153SmEDTMP can increase the remission rate of bone metastases.