Zenda Sadamoto, Nakagami Yoshihiro, Toshima Masamichi, Arahira Satoko, Kawashima Mitsuhiko, Matsumoto Yoshihisa, Kinoshita Hiroya, Satake Mitsuo, Akimoto Tetsuo
Departments of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan,
Int J Clin Oncol. 2014 Aug;19(4):739-43. doi: 10.1007/s10147-013-0597-7. Epub 2013 Jul 24.
Although the use of Sr-89 chloride in the treatment of patients with prostate and breast cancer has been widely reported, little information is available about its use for other malignancies. Here, we retrospectively analyzed the clinical profile of Sr-89 chloride in various patients with painful bone metastases.
Entry criteria were a pathologically proven malignancy, clinically diagnosed multiple bone metastases, and adequate organ function. Sr-89 chloride (Metastron) was given by single intravenous infusion at 2 MBq/kg over 2 min. Self-reported outcome measures were used as a response index, including pain diary data on a 0-10 numeric rating scale (NRS).
Fifty-four consecutive patients with painful bone metastases were treated with Sr-89 chloride at the National Cancer Center Hospital East between March 2009 and July 2011, consisting of 26 with breast/prostate cancer and 28 with other malignancies (lung 8, head and neck 6, colorectal 6, others 8). Thirteen (24 %) patients experienced a transient increase in pain, which was categorized as a flare-up response. Grade 3-4 anemia was observed in 6 patients, 3 of whom required blood transfusion. Regarding efficacy, response rates and complete response rates were 71.2 % and 34.6 %, respectively, and time to response from the initiation of treatment was 36 days (range, 13-217). No significant difference in response rates was seen between patients with breast/prostate cancer and other cancers (breast/prostate 69.2 %, other 73.1 %; p = 0.76).
As in patients with breast and prostate cancer, Sr-89 chloride is a promising agent for the treatment of painful bone metastases in patients with various other malignancies.
尽管氯化锶-89用于治疗前列腺癌和乳腺癌患者的情况已有广泛报道，但关于其用于其他恶性肿瘤的信息却很少。在此，我们回顾性分析了氯化锶-89在各种伴有疼痛性骨转移患者中的临床情况。
纳入标准为经病理证实的恶性肿瘤、临床诊断为多发骨转移以及器官功能良好。以2兆贝可/千克的剂量在2分钟内通过单次静脉输注给予氯化锶-89（美他生）。采用自我报告的结果测量作为反应指标，包括疼痛日记数据，采用0至10的数字评分量表（NRS）。
2009年3月至2011年7月期间，国立癌症中心东医院对54例连续的伴有疼痛性骨转移的患者使用了氯化锶-89进行治疗，其中26例为乳腺癌/前列腺癌患者，28例为其他恶性肿瘤患者（肺癌8例、头颈部癌6例、结直肠癌6例、其他8例）。13例（24%）患者经历了疼痛的短暂加重，这被归类为闪烁反应。6例患者观察到3 - 4级贫血，其中3例需要输血。关于疗效，缓解率和完全缓解率分别为71.2%和34.6%，从开始治疗到出现缓解的时间为36天（范围为13 - 217天）。乳腺癌/前列腺癌患者和其他癌症患者之间的缓解率无显著差异（乳腺癌/前列腺癌69.2%，其他73.1%；p = 0.76）。
与乳腺癌和前列腺癌患者一样，氯化锶-89是治疗各种其他恶性肿瘤患者疼痛性骨转移的一种有前景的药物。
