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目的评价烟酰胺和碳合氧(Carbogen)增敏89Sr治疗多发性骨转移癌的作用、骨痛的缓解及毒副反应。方法97例恶性肿瘤多发性骨转移患者随机分为4组烟酰胺+Carbogen+89Sr治疗组(A组);烟酰胺+89Sr治疗组(B组);Carbogen+89Sr治疗组(C组);89Sr治疗组(D组)。89SrCl2治疗采用1.48～2.22MBq/kg,静脉注射。注射89Sr前1h开始给予烟酰胺,6g/d,分3次口服,连服5d。首次口服烟酰胺后开始吸入Carbogen(95%O2+5%CO2)气体,6L/min,10min,每日1次,连续5d。结果A组治疗后骨痛的缓解及生活质量较B组、C组及D组有效率高(91.7%、77.3%、76.0%和69.2%),且A组与D组比较差异有统计学意义(P=0.048)。治疗后3个月复发性骨转移癌全身骨显像反应,各组之间差异无统计学意义。各组病人治疗后均有Ⅰ～Ⅱ度骨髓抑制,各组之间差异无统计学意义。结论烟酰胺+Carbogen+89Sr治疗多发性骨转移癌,对骨痛的缓解及生活质量的改善有更好的疗效,且未增加89Sr的治疗毒性反应。
Objective To evaluate the effect of nicotinamide and carbbogen sensitizing 89Sr on the treatment of multiple bone metastases, the relief of pain and the side effects. Methods Ninety-seven patients with multiple bone metastases of malignant tumors were randomly divided into four groups: nicotinamide + Carbogen + 89Sr group (group A), niacinamide + 89Sr group (group B), Carbogen + 89Sr group (group C) Treatment group (group D). 89SrCl2 treatment using 1.48 ~ 2.22MBq / kg, intravenous injection. Nicotinamide (6g / d) was given 1h prior to injection of 89Sr and administered orally 3 times for 5 days. After the first oral administration of nicotinamide inhalation Carbogen (95% O2 + 5% CO2) gas, 6L / min, 10min, once daily for 5d. Results The pain relief and quality of life in group A were more effective than those in group B, C and D (91.7%, 77.3%, 76.0% and 69.2%, respectively), and there was significant difference between group A and group D (P = 0.048). 3 months after treatment of recurrent bone metastases of the whole body bone imaging reaction, the difference between the groups was not statistically significant. All patients had grade Ⅰ ~ Ⅱ myelosuppression after treatment, with no significant difference between the groups. Conclusions Nicotinamide + Carbogen + 89Sr can treat multiple bone metastases with better curative effect on the relief of bone pain and quality of life, and does not increase the therapeutic toxicity of 89Sr.