Lovera C, Massardo T, Galleguillos M C, González P, Comparini B, Yáñez M, Fodor M, Gil M C, Araya G, Tomicic M
Centro de Medicina Nuclear, Hospital Clínico, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 1998 Aug;126(8):963-71.
Samarium153 EDTMP, a beta and gamma emitter, is used in the palliative therapy of painful bone metastases.
To evaluate the analgesic effects and myelotoxicity of Samarium153 EDTMP in patients with prostate, breast and renal carcinoma.
Twenty patients with bone metastases (11 males), aged 65 years old as a mean, received a 1 to 2 mCi/kg intravenous dose of Samarium153 EDTMP, produced in Chile. Patients were followed thereafter during 4 to 40 weeks. Pain was assessed using a visual analogue scale.
Pain decreased from a score of 6.4 prior to treatment, to 2.7 at the fourth week of therapy and the effect lasted a mean of 12.5 weeks. Myelotoxicity was observed in 68% of cases (WHO stage I in 21%, stage II in 37%, stage III in 11% and no patients in stage IV). Platelets were the most affected series and neutrophils the least affected. Cell counts returned to normal between the sixth and eighth week. Seventy nine percent of patients decreased their basal analgesic therapy at the sixth week and 88% did so at the eighth week. Forty one percent of these patients discontinued all analgesics.
Samarium153 EDTMP is effective in the treatment of pain in patients with bone metastases and its myelotoxicity is low to moderate. It should be considered as a therapy for this type of pain, with the precaution of performing periodical bood counts.
钐153乙二胺四甲撑膦酸（Samarium153 EDTMP）是一种β和γ射线发射体，用于疼痛性骨转移瘤的姑息治疗。
评估钐153乙二胺四甲撑膦酸对前列腺癌、乳腺癌和肾癌患者的镇痛效果及骨髓毒性。
20例骨转移患者（11例男性），平均年龄65岁，静脉注射智利生产的钐153乙二胺四甲撑膦酸，剂量为1至2毫居里/千克。此后对患者进行4至40周的随访。使用视觉模拟量表评估疼痛程度。
疼痛评分从治疗前的6.4降至治疗第4周时的2.7，效果平均持续12.5周。68%的病例观察到骨髓毒性（世界卫生组织I期占21%，II期占37%，III期占11%，无IV期患者）。血小板受影响最严重，中性粒细胞受影响最小。细胞计数在第6至8周恢复正常。79%的患者在第6周减少了基础镇痛治疗，88%的患者在第8周减少了基础镇痛治疗。其中41%的患者停用了所有镇痛药。
钐153乙二胺四甲撑膦酸对骨转移患者的疼痛治疗有效，其骨髓毒性为低至中度。应将其视为这类疼痛的一种治疗方法，但需定期进行血常规检查。
