Kim S I, Chen D C, Muggia F M
Division of Medical Oncology, University of Southern California School of Medicine, Los Angeles 90033.
Anticancer Res. 1988 Jul-Aug;8(4):681-4.
Bone-seeking radionuclides have been used to treat bone pain due to metastatic bone disease for over 40 years. More than 10 clinical studies using radiostrontium (Sr-89) have shown benefit in about 70-80% of patients having refractory bone pain from prostate, breast and other metastatic bone cancers, with minimal hematological toxicity. Other radionuclides, such as, radiophosphate (P-32), Yttrium-90, lodine-131, Rhenium-186, have also been used. Tumor necrosis has been found within the range of beta irradiation from the surrounding shell of bone incorporating the radionuclide. New strategies using radionuclides may be able to provide more effective methods of treatment, perhaps, beyond palliation. For example, the effect of low dose continuous radiation can be potentiated by hypoxic cell sensitizers. In addition, the kinetics of radionuclide uptake and retention can be modulated to increase the dose of radiation delivered to osteoblastic metastatic lesions, such as osteosarcoma.
骨靶向放射性核素已用于治疗转移性骨病引起的骨痛超过40年。超过10项使用放射性锶（Sr-89）的临床研究表明，约70-80%患有前列腺癌、乳腺癌和其他转移性骨癌难治性骨痛的患者从中受益，血液学毒性极小。其他放射性核素，如放射性磷酸盐（P-32）、钇-90、碘-131、铼-186，也已被使用。在包含放射性核素的骨周围壳层的β辐射范围内发现了肿瘤坏死。使用放射性核素的新策略或许能够提供更有效的治疗方法，可能超越姑息治疗。例如，低剂量连续辐射的效果可通过乏氧细胞增敏剂增强。此外，可调节放射性核素摄取和滞留的动力学，以增加传递至成骨性转移病灶（如骨肉瘤）的辐射剂量。
