Wang Rong Fu, Zhang Chun Li, Zhu Shou Li, Zhu Mei
Department of Nuclear Medicine, Peking University First Hospital, Beijing, China.
Med Princ Pract. 2003 Apr-Jun;12(2):97-101. doi: 10.1159/000069120.
To assess the therapeutic efficacy and toxicity of samarium-153-ethylenediaminetetramethylene phosphonic acid ((153)Sm-EDTMP) and pamidronate disodium in patients with painful metastatic bone cancer.
Eighteen patients with histopathologically confirmed malignancy and multifocal bone metastases were randomized into two equal groups of 9 patients each. Group A was treated with (153)Sm-EDTMP, while group B was treated with pamidronate disodium. The pain score for each patient was recorded before and after therapy using visual analogue scales that graded both the intensity and frequency of the bone pain. Therapeutic response was classified as inefficient, mild, effective and excellent.
Pain score in each group prior to therapy was more than 6. In group A, 2 (22.2%) and 7 (77.8%) cases showed mild and effective response, respectively. The therapeutic efficacy of (153)Sm-EDTMP was adjudged to be 77.8%. Transient myelosuppression was generally mild and reversible with white blood cells and platelets recovering after 6 weeks. In group B, palliative response in 4 cases (44.4%) was inefficient, in 1 case (11.1%) mild, in 3 cases (33.3%) effective and in 1 case (11.1%) excellent, with a therapeutic efficacy of 44.4% for pamidronate disodium. No hematological toxicity was noted.
The data showed that the therapeutic efficacy of (153)Sm-EDTPM was higher than that of pamidronate disodium (for pain relief maintained more than 3 weeks) and its incidence of blood toxicity was also higher than that of pamidronate disodium.
评估钐-153-乙二胺四亚甲基膦酸（（153）Sm-EDTMP）和帕米膦酸二钠对疼痛性转移性骨癌患者的治疗效果及毒性。
18例经组织病理学确诊为恶性肿瘤且有多发性骨转移的患者被随机分为两组，每组9例。A组接受（153）Sm-EDTMP治疗，而B组接受帕米膦酸二钠治疗。使用视觉模拟量表记录每位患者治疗前后的疼痛评分，该量表对骨痛的强度和频率进行分级。治疗反应分为无效、轻度、有效和优秀。
每组治疗前的疼痛评分均超过6分。A组中，2例（22.2%）显示轻度反应，7例（77.8%）显示有效反应。（153）Sm-EDTMP的治疗有效率判定为77.8%。短暂性骨髓抑制一般较轻且可逆，白细胞和血小板在6周后恢复。B组中，4例（44.4%）的姑息性反应无效，1例（11.1%）为轻度，3例（3,3%）为有效，1例（11.1%）为优秀，帕米膦酸二钠的治疗有效率为44.4%。未观察到血液学毒性。
数据表明，（153）Sm-EDTPM的治疗效果高于帕米膦酸二钠（疼痛缓解维持超过3周），其血液毒性发生率也高于帕米膦酸二钠。
