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首页> 外文期刊>Sao Paulo Medical Journal >Treatment of bone pain secondary to metastases using samarium-153-EDTMP
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Treatment of bone pain secondary to metastases using samarium-153-EDTMP

机译：使用sa153-EDTMP治疗继发于转移的骨痛

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CONTEXT: More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. OBJECTIVE: To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. TYPE OF STUDY: Retrospective. SETTING: Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). METHODS: Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). RESULTS: All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. DISCUSSION: Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. CONCLUSION: Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects.
机译：背景：超过50％的前列腺癌，乳腺癌或肺癌患者会发生痛苦的骨转移。治疗骨转移的目的是减轻疼痛，减少类固醇的使用并保持运动。目的：评估sa153-EDTMP（153Sm-EDTMP）在治疗继发于临床管理中难治的继发转移性骨痛中的应用。研究类型：回顾性。地点：坎皮纳斯Estadual大学（Unicamp）核医学科。方法：研究了58例平均年龄为62岁的男性（34例）。前列腺癌31例，乳腺癌20例，肺癌3例，肺血管内皮癌1例，甲状旁腺癌1例，骨肉瘤1例，原发性肿瘤不明1例。所有患者均经99mTc-MDP闪烁显像证实多发骨转移，并接受153Sm-EDTMP治疗。对治疗的反应分为好（疼痛减轻50-100％），中（25-49％）和差（0-24％）。结果：所有患者均显示骨转移对153Sm-EDTMP的吸收良好。在前列腺癌患者中，对治疗的中度或良好反应发生率为80.6％（25例患者），对反应的不良反应率为19.4％（6）。在乳腺癌患者中，有85％（17）的患者对治疗的反应中等或良好，而15％（3）的患者则反应较差。三名肺癌患者均显示出对治疗的不良反应。肺血管内皮细胞瘤和未知原发性病变患者对治疗的反应中等;骨肉瘤和甲状旁腺癌患者对治疗表现出良好的反应。没有发生明显的骨髓毒性。讨论：疼痛控制对于改善晚期癌症患者的生活质量至关重要。通过使用放射性核素缓解疼痛的机理仍未完全了解，但是，治疗方法简单，且发生细胞毒性的风险较低。结论：153Sm-EDTMP治疗可有效控制大多数乳腺癌和前列腺癌患者继发于骨转移的疼痛，而无明显副作用。

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