【摘要】 目的评价放射性核素153Sm2乙二胺四甲基膦酸(153Sm EDTMP)治疗骨转移癌的疗效及其对造血功能的影响。方法静脉注射153Sm EDTMP,每次0.5～1.5mCi kg体重。观察治疗前、后患者的生活质量、病灶及血细胞的变化。结果患者疼痛完全缓解率(CR)32.5%(13/40);部分缓解率(PR)50%(20/40);疾病进展(PD)17.5%(7/40);总有效率82.5%。单一应用153Sm EDTMP,剂量≤1mCi的患者,对造血功能影响较小,一般于治疗后4周基本恢复。剂量>1mCi或与化疗联合应用的患者,对造血功能影响较大,需用G_CSF或输血(包括脐血)治疗,约治疗后6周才能恢复。结论①153Sm_EDTMP是比较理想的治疗多发性骨转移癌的放射性核素之一,具有控制病情发展、消除骨转移灶,改善患者生活质量的作用;②153Sm_EDTMP治疗后可使患者血象一过性降低。剂量>1mCi,连续治疗2次以上者可诱发全血减少;③脐血有恢复射线所致的造血功能损伤的作用。更多还原

【Abstract】 Objective To evaluate the clinical effect and side-effect of hemapoietic function of the patients with metastatic bone cancer treated by 153Sm-EDTMP. Methods 153Sm-EDTMP dose was 0.5-1.5 mCi/kg per time by intravenous, The changes of life quality, cancer size and hemapoietic function before and after treatment with 153Sm-EDTMP were evaluated. Results After treatment with  153Sm-EDTMP, 32.5%(13/40) patients with pain achieved complete response, 50%(20/40) patients had partial response, up progressives were observed in 17.5%(7/40) patients, total effective rate was 82.5%. With Dose<1 mCi,  153Sm-EDTMP administered alone affected more slightly the hemapoiteic fuction of patient’s than that with dose >1 mCi, and recovered about four weeks after the treatment. With dose>1 mCi or  153Sm-EDTMP combinated with chmotherapy, the hemapoietic fuction was affected more obviouly. When WBC≤2×109/L, using G-CSF and cord blood to improve WBC level, patients recovered about six weeks after the treatment. Conclusion ① 153Sm-EDTMP treatment of metastatic bone cancer was effective, it can control focuses progress, eliminate metastatic bone focus and improve patient’s life quality; ② 153Sm-EDTMP affected the hemapoietic function. With dose≥1 mCi, if 153Sm-EDTMP was administered continuously for more than two times for treatment, whole blood was deceased. ③cord blood can be used to improve hemapoietic function. ;更多还原