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分析乳腺癌多发性骨转移的预后和153Sm 乙二胺四甲基膦酸 (EDTMP)治疗结果。方法 :回顾分析1992年至1998年131例接受了153Sm EDTMP治疗的乳腺癌多发性骨转移病人。所有病人经病理或细胞学证实为乳腺癌。骨转移灶经骨显像、X光片、CT和/或MRI诊断证实。结果 :全组病人总的5年生存率为59 % ,骨转移后5年生存率和中位生存期分别为18 5 %和15个月。转移局限于骨的病人比骨转移合并其它部位转移的病人生存期长 ,其相应的骨转移后5年生存率分别为26 3 %和13 7 %。所有多发性骨转移疼痛病人接受153Sm EDTMP治疗,治疗有效率为81 7 % ,其中完全缓解34 4 % ,部分缓解47 3 % ,无效率为18 3 %。骨核素治疗效果和预后相关 ,完全缓解的病人骨转移后生存率明显优于部分缓解或无效病人 ,其5年生存率分别为32 8 % ,10 4 %和11 4 % (P<0 001)。结论 :乳腺癌骨转移是一个相对缓慢的临床过程 ,153Sm EDTMP是多发性骨转移疼痛的有效治疗手段 ,其治疗疗效是预后的重要因素
To analyze the prognosis of multiple bone metastases in breast cancer and the results of 153Sm ethylenediamine tetramethylphosphonic acid (EDTMP) treatment. Methods: Retrospective analysis of 131 patients with multiple bone metastases treated with 153Sm EDTMP from 1992 to 1998. All patients were pathologically or cytologically confirmed as breast cancer. Bone metastases were confirmed by bone imaging, X-ray, CT, and/or MRI. Results: The overall 5-year survival rate for the whole group was 59%. The 5-year survival rate and median survival time after bone metastases were 185% and 15 months, respectively. Patients with metastases confined to bone had a longer survival period than those with bone metastases and other metastases. The corresponding 5-year survival rates after bone metastases were 263% and 137%, respectively. All patients with multiple bone metastases received 153Sm EDTMP treatment, and the effective rate was 81.7%, of which 34.4% were complete remission, 47.7% were partial remission, and the ineffective rate was 18.3%. The therapeutic effect of osteogenesis was related to prognosis. The survival rate after bone metastases was significantly better in patients with complete remission than those with partial remission or ineffective patients. The 5-year survival rates were 32 8%, 10 4 %, and 11 4 %, respectively (P<0 001). ). Conclusion : Bone metastasis of breast cancer is a relatively slow clinical process. 153Sm EDTMP is an effective treatment for multiple bone metastasis pain. Its therapeutic efficacy is an important factor in prognosis.