Gunawardana Dishan H, Lichtenstein Meir, Better Nathan, Rosenthal Mark
Nuclear Medicine Department, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Clin Nucl Med. 2004 Feb;29(2):81-5. doi: 10.1097/01.rlu.0000109721.58471.44.
Strontium-89 (Sr-89) chloride is an effective palliative treatment of the bone metastases of prostate cancer. Chemotherapy has also been shown to have a palliative benefit in this disease. We aimed to determine the benefits and complications of Sr-89 therapy in patients with prostate cancer who had become refractory to chemotherapy. We conducted a retrospective review of 14 treatments administered to 13 patients with chemotherapy-resistant and hormone-resistant prostate cancer.
Of the 14 administered treatments, 8 (57%) resulted in improved pain control, with 2 patients able to stop analgesia. The median duration of response was 56 days. No prostate-specific antigen response was seen in the 8 patients tested. There was significant and prolonged bone marrow toxicity, with 6 patients requiring red blood cell transfusion. Prolonged thrombocytopenia was seen, with platelet counts remaining below baseline levels after treatment in all but one patient. Leukopenia was generally mild and not associated with infection.
Sr-89 is an effective treatment of patients with chemotherapy-refractory prostate cancer, but careful and prolonged monitoring of hematologic parameters after therapy is required.
氯化锶-89(Sr-89)是前列腺癌骨转移的一种有效姑息治疗方法。化疗在该疾病中也已显示出有姑息治疗益处。我们旨在确定Sr-89治疗对化疗难治性前列腺癌患者的益处和并发症。我们对13例化疗耐药且激素抵抗性前列腺癌患者接受的14次治疗进行了回顾性分析。
在14次治疗中,8次(57%)使疼痛控制得到改善,2例患者能够停用镇痛药。中位反应持续时间为56天。在接受检测的8例患者中未观察到前列腺特异性抗原反应。存在显著且持续时间长的骨髓毒性,6例患者需要输注红细胞。出现了持续性血小板减少,除1例患者外,所有患者治疗后的血小板计数均低于基线水平。白细胞减少一般较轻,且与感染无关。
Sr-89是化疗难治性前列腺癌患者的一种有效治疗方法,但治疗后需要对血液学参数进行仔细且长期的监测。