Tian Jiahe, Cao Limin, Zhang Jinming, Ouyang Qiaohong, Hou Qingtian, He Yijie
Department of Nuclear Medicine, PLA General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2002 Jun;115(6):824-8.
A certain fraction of patients failed palliative treatment of 153Sm- ethylenediaminetetramethy lenephosphate (153Sm-EDTMP) for painful skeletal metastases were reviewd. A comparative analysis was designed to identify the factors related to therapeutic response.
From a 3-year multi-center clinical trial, 51 cases were collected who did not respond to an intravenous injection of 153Sm-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.
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.
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 153Sm-EDTMP palliation. Further exploration of a better way to determine dosage and predict response for each individual case is needed.
回顾部分接受153钐-乙二胺四甲基膦酸（153Sm-EDTMP）姑息治疗的骨转移疼痛患者的情况。设计一项对比分析以确定与治疗反应相关的因素。
从一项为期3年的多中心临床试验中，收集51例对静脉注射剂量为0.5 - 1.5毫居里/千克的153Sm-EDTMP无反应的患者。通过症状变化、一般状况、镇痛药消耗量、疗效乘积总和以及卡诺夫斯基评分来评估治疗效果。将这些患者的年龄、性别、治疗史、肿瘤类型、骨受累部位、摄取率和转移灶数量以及患者使用的剂量与有反应的患者进行比较。
在51例无反应者中，43例为男性，34例患有肺癌，41例椎体有骨病变，39例骨盆有骨病变，24例下肢有转移灶。有反应者和无反应者在性别分布、肿瘤类型和病变部位方面存在显著差异。两组之间其他因素无差异。虽然临床观察发现年龄较小的患者以及放射性药物摄取较低的病变似乎更容易治疗失败，但这未得到统计学分析的证实。
发现患者的性别、某些原发性肿瘤类型以及身体下部的转移灶会影响患者对单剂量153Sm-EDTMP姑息治疗的反应。需要进一步探索更好的方法来确定剂量并预测每个病例的反应。
