Skóra Tomasz, Kowalska Teresa, Zawiła Krystyna
Gastrointestinal and Genitourinary Cancer Department, Maria Skłodowska-Curie Memorial Institute of Oncology, Branch in Krakow, Poland.
Contemp Oncol (Pozn). 2012;16(3):201-5. doi: 10.5114/wo.2012.29284. Epub 2012 Jul 6.
Metastatic bone disease is a major clinical and therapeutic problem. It is particularly marked in patients with advanced breast and prostate cancer. Taking into account the diversity of the consequences of skeletal metastases, multidisciplinary patient care should be provided. Among the available treatment methods, radionuclide therapy plays a significant role. The goal of the study was to evaluate and compare the effectiveness of treatment with radionuclides of strontium-89 and samarium-153 in patients with generalized bone metastases.
We analyzed 132 patients with poor pharmacological control of bone pain, caused by multiple metastases due to breast or prostate cancer. In this group of patients radionuclide therapy was administered in the Krakow branch of Oncology Centre between 2002 and 2010.
In the group treated with strontium-89 and samarium-153 total analgesic response rate obtained, was 69% and 83.3%, respectively. In both groups, a significant reduction in analgesics consumption was observed, higher in the group treated with samarium-153. In 14 patients with satisfactory analgesic effect after the first administration of a radioisotope, second administration of radionuclide therapy was attempted at the time of symptoms reappearance. The positive response was achieved in 12 patients. Treatment with both radionuclides was well tolerated.
Radionuclide therapy with strontium-89 and samarium-153 is effective and well tolerated treatment of pain caused by the skeletal metastases. In some cases it is possible to obtain equally good analgesic effect with repeated radioisotopes administration.
骨转移疾病是一个主要的临床和治疗问题。在晚期乳腺癌和前列腺癌患者中尤为明显。考虑到骨转移后果的多样性,应提供多学科的患者护理。在现有的治疗方法中,放射性核素治疗起着重要作用。本研究的目的是评估和比较锶-89和钐-153放射性核素治疗全身骨转移患者的有效性。
我们分析了132例因乳腺癌或前列腺癌多处转移导致骨痛药物控制不佳的患者。2002年至2010年期间,在肿瘤中心的克拉科夫分院对这组患者进行了放射性核素治疗。
在接受锶-89和钐-153治疗的组中,总镇痛有效率分别为69%和83.3%。两组均观察到镇痛药消耗量显著减少,钐-153治疗组减少幅度更大。14例在首次给予放射性同位素后镇痛效果满意的患者,在症状复发时尝试进行第二次放射性核素治疗。12例患者获得了阳性反应。两种放射性核素治疗的耐受性都很好。
锶-89和钐-153放射性核素治疗对骨转移引起的疼痛有效且耐受性良好。在某些情况下,重复给予放射性同位素可能获得同样良好的镇痛效果。