Silberstein E B
University of Cincinnati Medical Center, Cincinnati, OH 45219, USA.
Semin Radiat Oncol. 2000 Jul;10(3):240-9. doi: 10.1053/srao.2000.6592.
Bone pain from osteoblastic metastases can be ameliorated 40% to 80% of the time. Although we can predict nonresponders, we cannot predict responders; however, patients with a better performance scale may have a better chance of pain relief. Radiopharmaceuticals containing phosphorus 32, strontium 89, samarium 153, rhenium 186, and tin 117m are effective, but we do not know which is the most efficacious and the safest. Toxicity includes the flare phenomenon and mild to moderate pancytopenia, but disseminated intravascular coagulation can cause severe, life-threatening thrombocytopenia. This treatment may be repeated at about 9- to 12-week intervals, perhaps earlier with (153)Sm lexidronam, (186)Re etidronate, and (117m)Sn pentetate, with a success rate approaching that of the initial injection. The duration of action of pain reduction ranges from 2 weeks to many months. Tumorical effects are probably not the only mechanism of pain relief.
成骨性转移引起的骨痛在40%至80%的情况下可得到缓解。虽然我们能够预测无反应者，但无法预测有反应者；不过，身体状况较好的患者疼痛缓解的机会可能更大。含磷32、锶89、钐153、铼186和锡117m的放射性药物有效，但我们不清楚哪种最有效且最安全。毒性包括闪燃现象和轻至中度全血细胞减少，但弥散性血管内凝血可导致严重的、危及生命的血小板减少。这种治疗可每隔约9至12周重复进行，使用（153）钐-乙二胺四甲撑膦酸、（186）铼-依替膦酸盐和（117m）锡-喷替酸时可能间隔时间更短，成功率接近初次注射。疼痛减轻的作用持续时间从2周至数月不等。肿瘤效应可能并非疼痛缓解的唯一机制。
