Saito Anneyuko I, Inoue Tatsuya, Kinoshita Makiko, Kosaka Takahiro, Mitsuhashi Taira
Department of Radiation Oncology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Department of Radiology, Juntendo Univeristy Urayasu Hospital, Chiba, Japan.
Ir J Med Sci. 2023 Apr;192(2):569-574. doi: 10.1007/s11845-022-03023-9. Epub 2022 May 10.
Re-irradiation of a previously irradiated site must be done with careful consideration to minimize dose to organs at risk.
To evaluate pain response and safety of Sr-89 administration for painful bone metastases after prior irradiation.
We retrospectively reviewed patients with Sr-89 injection for painful bone metastasis in a previously irradiated site. All patients were seen in follow-up at 1, 2, 3, and 4 months after injection and every 6 months thereafter. Pain control, toxicity, and pain progression-free survival were analyzed. Correlation of pain relapse with the following characteristics was analyzed: gender, age, primary tumor, tumor pathology, baseline performance status, and baseline verbal rating scale.
Among 25 patients analyzed (10 male, 15 female), median age was 68 (range, 50-81) years. Primary tumor sites included lung (n = 11), breast (n = 3), uterine cervix (n = 3), prostate (n = 3), and others (n = 5). Median follow-up was 25 (range, 1-76) months. Pain relief was observed in 24 patients (96.0%). One- and 2-year pain progression-free survival rates in these patients were 54.5% and 48.4%, respectively. Median time to pain progression was 5 (range, 2-16) months. Statistically significantly lower pain progression-free survival was observed in patients with osteolytic bone metastases (p < 0.01). No grade 3 or worse adverse events were observed.
Sr-89 injection showed pain relief in most of our patients with painful bone metastases in a previously irradiated site and caused no grade 3 or worse adverse events. Sr-89 is an option for patients with a painful bone metastasis in a previously irradiated site.
对先前接受过照射的部位进行再照射时，必须谨慎考虑，以尽量减少对危及器官的剂量。
评估锶-89治疗先前照射后出现的疼痛性骨转移的疼痛反应和安全性。
我们回顾性分析了在先前照射部位接受锶-89注射治疗疼痛性骨转移的患者。所有患者在注射后1、2、3和4个月进行随访，此后每6个月随访一次。分析疼痛控制、毒性和无疼痛进展生存期。分析疼痛复发与以下特征的相关性：性别、年龄、原发肿瘤、肿瘤病理、基线体能状态和基线言语评定量表。
在分析的25例患者中（男性10例，女性15例），中位年龄为68岁（范围50-81岁）。原发肿瘤部位包括肺（n = 11）、乳腺（n = 3）、子宫颈（n = 3）、前列腺（n = 3）和其他（n = 5）。中位随访时间为25个月（范围1-76个月）。24例患者（96.0%）出现疼痛缓解。这些患者的1年和2年无疼痛进展生存率分别为54.5%和48.4%。疼痛进展的中位时间为5个月（范围2-16个月）。溶骨性骨转移患者的无疼痛进展生存期在统计学上显著较低（p < 0.01）。未观察到3级或更严重的不良事件。
锶-89注射使我们大多数先前照射部位疼痛性骨转移患者的疼痛得到缓解，且未引起3级或更严重的不良事件。锶-89是先前照射部位疼痛性骨转移患者的一种选择。
