Research Oncology, Division of Cancer Studies, Kings College London, and Clinical Oncology, Guys and St Thomas' Hospitals, London, UK.
Semin Nucl Med. 2013 Jul;43(4):317-23. doi: 10.1053/j.semnuclmed.2013.02.002.
The skeleton is commonly affected in the context of metastatic breast cancer and is a cause of significant morbidity in these individuals. Therapeutic options include systemic therapy, radiotherapy, and surgery given with the intent of preserving function and quality of life. As the spectrum of available therapies increases, key challenges comprise reliable diagnosis of bony metastatic disease and accurate evaluation of response that permits rapid therapeutic transition in those responding inadequately prior to development of significant skeletal morbidity. The (99m)Tc-diphosphonate bone scan remains one of the most commonly requested investigations for skeletal evaluation in patients with breast cancer. However a time lag of 3-6 months for accurate response evaluation from the start of treatment limits its utility for response evaluation in routine clinical practice or as a progression end point in the research setting. Functional imaging strategies using more tumor-specific radiopharmaceuticals show promise as an effective means of imaging response at a clinically relevant time point and are the subject of this review.
在转移性乳腺癌的背景下，骨骼通常会受到影响，这也是这些患者出现高发病率的原因。治疗选择包括全身性治疗、放疗和手术，其目的是保留功能和生活质量。随着可用治疗方法的增多，可靠的骨转移疾病诊断和准确的反应评估成为了关键挑战，这使得在出现明显骨骼发病率之前，能够快速对反应不足的患者进行治疗转换。(99m)Tc-双膦酸盐骨扫描仍然是乳腺癌患者骨骼评估中最常要求的检查之一。然而，从治疗开始到准确评估反应之间存在 3-6 个月的时间滞后，限制了其在常规临床实践中的反应评估或作为研究中进展终点的实用性。使用更具肿瘤特异性放射性药物的功能成像策略有望成为在临床相关时间点进行反应成像的有效手段，这也是本文综述的主题。
