CAJ | 학술논문

目的通过对比分析153Sm-EDTMP治疗转移癌性骨痛有效与无效病例,探讨影响153Sm-EDTMP 治疗效果的相关因素.方法按国际原子能机构区域合作计划组织中国多中心研究, 3年内收集153Sm-EDTMP 治疗转移癌性骨痛234例.根据治疗响应分为有效及无效两组、比较其个人情况、临床特点、原发病种、骨转移特点、及治疗方法等因素,以SAS软件进行分组与多因素分析.结果 183例治疗有效,51例治疗无效,两组间在年龄、非核素治疗、 153 Sm-EDTMP用量、转移灶数目、病灶占全身骨骼比重、摄取程度等方面无明确差别.但无效组中男性43例(84.3%),肺癌34例(66.7%),脊柱、骨盆与下肢转移的比例明显不同于有效组.多因素分析证实患者性别、肿瘤类型和转移部位与治疗效果相关.结论 153Sm-EDTMP治疗时,肺癌、男性、和下半身转移者可能效果差.尽管机制不详,了解这些因素有助于估计疗效.
목적통과대비분석153Sm-EDTMP치료전이암성골통유효여무효병례,탐토영향153Sm-EDTMP 치료효과적상관인소.방법안국제원자능궤구구역합작계화조직중국다중심연구, 3년내수집153Sm-EDTMP 치료전이암성골통234례.근거치료향응분위유효급무효량조、비교기개인정황、림상특점、원발병충、골전이특점、급치료방법등인소,이SAS연건진행분조여다인소분석.결과 183례치료유효,51례치료무효,량조간재년령、비핵소치료、 153 Sm-EDTMP용량、전이조수목、병조점전신골격비중、섭취정도등방면무명학차별.단무효조중남성43례(84.3%),폐암34례(66.7%),척주、골분여하지전이적비례명현불동우유효조.다인소분석증실환자성별、종류류형화전이부위여치료효과상관.결론 153Sm-EDTMP치료시,폐암、남성、화하반신전이자가능효과차.진관궤제불상,료해저사인소유조우고계료효.
Objective A certain fraction of patients failed palliative treatment of 153 Sm-ethylenediaminetetramethy lenephosphate (153Sm-EDTMP) for painful skeletal metastases were reviewd. A comparative analysis was designed to identify the factors related to therapeutic response. Methods From a 3-year multi-center clinical trial, 51 cases were collected who did not respond to an intravenous injection of 153 Sm-EDTMP at a dosage of 0.5-1.5 mCi/kg. The therapeutic efficacy was evaluated via changes of symptoms, general condition, consumption of analgesics, sum of effect product, and Karnofsky scores. The age, sex, history of treatment, tumor type, location of bony involvement, uptake ratio and number of metastases, and doses used by the patients were compared to those of the responders. Results In 51 non-responders, 43 were male, 34 suffered from lung cancer, 41 had bone lesions in the vertebrae, 39 in the pelvis, and 24 had metastases in the lower extremities. Sex distribution, tumor type and location of the lesion differed significantly between responders and non-responders. No other factor showed differences between the two groups. Though patients of younger age, and lesions with lower uptake of radiopharmaceutical seemed to fail the treatment more easily as observed clinically, this was not confirmed by statistical analysis. Conclusion The sex of the patients, certain types of primary tumors and metastases to lower parts of the body were found to influence the patients' response to a single dose of 153 Sm-EDTMP palliation. Further exploration of a better way to determine dosage and predict response for each individual case is needed.