CAJ | 학술논문

目的：探讨转移性骨癌患者采用不同剂量188铼-羟基亚乙基二膦酸盐（188 Re-HEDP）治疗的临床疗效及不良反应。方法采用188 Re-HEDP治疗90例转移性骨癌患者，按照治疗剂量分组为甲、乙、丙3组，各30例。甲组为低剂量组，14．8～18．5 MBq／kg 188 Re-HEDP；乙组为中剂量组，18．9～25．9 MBq／kg；丙组为高剂量组，26．3～37．0 MBq／kg。静脉一次性给药，1次／月，3次为1疗程。根据患者实际病情和转移病灶多少及治疗后疗效反应情况给予其1～2个疗程治疗。观察3组患者镇痛和临床消退骨转移的疗效及不良反应。结果甲、乙、丙3组镇痛疗效分别为60．00％（18／30）、86．67％（26／30）、90．00％（27／30）。乙、丙组与甲组比较，P＜0．05；乙丙组比较，P＞0．05。甲、乙、丙3组骨转移临床疗效分别为13．33％（4／30）、20．00％（6／30）、16．67％（5／30）；3组比较，P＞0．05。3组患者均出现血小板降低和白细胞下降，但3组比较，P＞0．05；3组治疗后均出现反跳痛（ P＞0．05）。结论临床采用中剂量（18．9～25．9 MBq／kg）188铼-羟基亚乙基二膦酸盐治疗转移性骨癌患者，不但具有较好镇痛效果，还对部分转移病灶具有较好消退效果，且临床不良反应较少，值得进行进一步研究与分析。
목적：탐토전이성골암환자채용불동제량188래-간기아을기이련산염（188 Re-HEDP）치료적림상료효급불량반응。방법채용188 Re-HEDP치료90례전이성골암환자，안조치료제량분조위갑、을、병3조，각30례。갑조위저제량조，14．8～18．5 MBq／kg 188 Re-HEDP；을조위중제량조，18．9～25．9 MBq／kg；병조위고제량조，26．3～37．0 MBq／kg。정맥일차성급약，1차／월，3차위1료정。근거환자실제병정화전이병조다소급치료후료효반응정황급여기1～2개료정치료。관찰3조환자진통화림상소퇴골전이적료효급불량반응。결과갑、을、병3조진통료효분별위60．00％（18／30）、86．67％（26／30）、90．00％（27／30）。을、병조여갑조비교，P＜0．05；을병조비교，P＞0．05。갑、을、병3조골전이림상료효분별위13．33％（4／30）、20．00％（6／30）、16．67％（5／30）；3조비교，P＞0．05。3조환자균출현혈소판강저화백세포하강，단3조비교，P＞0．05；3조치료후균출현반도통（ P＞0．05）。결론림상채용중제량（18．9～25．9 MBq／kg）188래-간기아을기이련산염치료전이성골암환자，불단구유교호진통효과，환대부분전이병조구유교호소퇴효과，차림상불량반응교소，치득진행진일보연구여분석。
Objective To study the clinical efficacy and adverse reactions of different doses of 188 rhenium-hydroxy ethyl-idene diphosphonate ( 188 Re-HEDP) for metastatic bone cancer .Methods 90 cases of metastatic bone cancer treated with 188 Re-HEDP,in accordance with the treatment dose ,were grouped into group A ,B,C,each with 30 cases.Group A was the low-dose group,received 14.8 ~18.5 MBq/kg 188 Re-HEDP;group B was the medium-dose group,received 18.9 ~25.9 MBq/kg 188 Re-HEDP;Group C was the high-dose group,received 26.3 ~37.0 MBq/kg 188 Re-HEDP;patients received disposable intravenous administration,1 time /month,3 times was 1 course.According to the condition of patients ,actual number of metastatic lesions and treatment efficacy response ,patients received 1 to 2 courses of treatment .Efficacy of analgesic and clinical regression of bone metastases,and adverse reactions of the 3 groups were observed.Results Analgesic efficacy of group A,B,C were 60.00%(18/30),86.67%(26/30),90.00% (27/30),there had no significant difference between group B ,C and group A (P<0.05);there had no significant difference between group B and group C (P>0.05).Bone metastases clinical efficacy of group A ,B,C were 13.33%(4/30),20.00%(6/30),16.67%(5/30),there had no significant difference among the 3 groups (P>0.05). There had no significant difference among the 3 groups in thrombocytopenia and leukopenia (P>0.05);after treatment,the 3 groups had rebound tenderness (P>0.05).Conclusion 18.9~25.9 MBq/kg of 188Re-HEDP for metastatic bone cancer has good analgesic effect ,and it has regression effect for part of metastatic lesions with fewer clinical adverse reactions ,it is worthy of further study and analysis .