Srivastava S C, Atkins H L, Krishnamurthy G T, Zanzi I, Silberstein E B, Meinken G, Mausner L F, Swailem F, D'Alessandro T, Cabahug C J, Lau Y, Park T, Madajewicz S
Medical Department, Brookhaven National Laboratory, Upton, New York 11973-5000, USA.
Clin Cancer Res. 1998 Jan;4(1):61-8.
The physical characteristics of Sn-117m combined with the biodistribution of the compound tin-117m (Stannic, 4+) diethylenetriaminepentaacetic acid (Sn-117m DTPA) suggest that it should be an excellent agent for the palliation of pain from bony metastases. Prior work has established the dosimetry and the safety for the material in human beings. The presence of low-energy conversion electrons should result in the relative sparing of the bone marrow while delivering a high radiation dose to sites of bony metastatic disease. Forty-seven patients with painful bone metastases from various malignancies were treated with Sn-117m DTPA. The patients were assigned to five different dose levels ranging from 2.64 to 10.58 MBq (71-286 microCi) per kg of body weight. Follow-up included review of pain diaries, performance scores, analgesic requirements, blood chemistries, and hematological assessment. Three patients received a second treatment. There was an overall response rate for relief of pain of 75% (range, 60-83%) in the 40 treatments that could be evaluated. No correlation was apparent in this limited series between response rate and the five dose levels used. The relief was complete in 12 patients (30%). The time to onset of pain relief was 19 +/- 15 days with doses < or = 5.29 MBq/kg and 5 +/- 3 days with doses > or = 6.61 MBq/kg. Myelotoxicity was minimal, with only one patient having a marginal grade 3 WBC toxicity. On the basis of our data, Sn-117m DTPA should be an effective and safe radiopharmaceutical for palliation of painful bony metastases. A large-scale trial is warranted to evaluate it in comparison to other similar agents.
锡 - 117m的物理特性与化合物锡 - 117m（四价锡，Sn4 +）二乙三胺五乙酸（Sn - 117m DTPA）的生物分布表明，它应该是缓解骨转移疼痛的理想药物。先前的研究已经确定了该物质在人体中的剂量学和安全性。低能转换电子的存在应能在向骨转移疾病部位输送高辐射剂量的同时，相对保护骨髓。47例患有各种恶性肿瘤引起的骨转移疼痛的患者接受了Sn - 117m DTPA治疗。患者被分配到五个不同的剂量水平，范围为每公斤体重2.64至10.58 MBq（71 - 286微居里）。随访包括审查疼痛日记、体能评分、镇痛药物需求、血液化学检查和血液学评估。3例患者接受了第二次治疗。在可评估的40次治疗中，疼痛缓解的总体有效率为75%（范围为60 - 83%）。在这个有限的系列中，有效率与所使用的五个剂量水平之间没有明显的相关性。12例患者（30%）疼痛完全缓解。剂量≤5.29 MBq/kg时，疼痛缓解开始时间为19±15天；剂量≥6.61 MBq/kg时，为5±3天。骨髓毒性极小，只有1例患者有轻微的3级白细胞毒性。根据我们的数据，Sn - 117m DTPA应该是一种有效且安全的用于缓解骨转移疼痛的放射性药物。有必要进行大规模试验以与其他类似药物进行比较评估。
