89Sr联合外放疗治疗骨转移癌大病灶的疗效研究.DOC

89Sr联合外放疗治疗骨转移癌大病灶的疗效评价 段云 武鸿文 徐蓉生 赵力威 向光华 刘晓铃 四川省肿瘤医院核医学科，成都，610041 【摘要】 目的 评价放射性核素89Sr 治疗配合局部外放疗治疗骨转移癌大病灶的疗效，分析单纯核素89Sr治疗、单纯局部外放疗治疗及联合治疗的副作用。方法 观察68例确诊为骨转移癌伴有大病灶的患者，分为3组，单纯放射性核素89Sr治疗(A组)21例，静脉内注射111148 MBq；局部外放疗(B组)19例，采用6MV直线加速器外照射，放疗剂量为 DT3000 cGy/10次或4000 cGy/20次，单次为612 Gy；89Sr治疗+局部外放疗(C组)28例，两种联合治疗。结果 治疗后C组骨痛缓解、显像改善明显于AB组(P0.05)；AC组新增病灶较B组得到明显控制(P0.05)。治疗后血液学的毒性反应3组差异无统计学意义(P0.05)。结论 核素89Sr治疗联合局部外放疗对骨转移癌大病灶有较好的止痛，对患者骨转移有较好控制，是目前治疗骨转移大病灶有效、安全措施之一。 【关键词】肿瘤骨转移；放射疗法；锶放射性同位素Research of the effects on combination with radio-nuclide 89Sr and local radiotherapy to treat big lesions bone metastasis cancer DUAN Yun , WU hongwen,XU Rongsheng ,Zhao Liwei, Xiang Guanhua, Liu Xiaoling. Department of Nuclear Medicine, Sichuan Cancer Hospital, Chengdu,China 610041 【Abstract】 Objective To evaluate the effects on radionuclide 89Sr and local radiotherapy to treat cancer with big lesions bone metastasis, analysis side effects of radionuclide pure 89Sr therapy，local and external radiation therapy, and combined treatment. Methods 68 cases who diagnosed as bone metastasis associated with large lesions of patients ， divided into 3 groups，pure 89Sr radionuclide therapy (group A) 21 cases，intravenously 111-148 MBq；the local radiotherapy，6MV adopts linear accelerator external radiation，radiation dose for DT3000cGy/ 10 times or 4000 cGy / 20 times，a single radiation dose for 6-12Gy；the local radiotherapy combined 89Sr treatment (group C) 28 cases，two kinds of therapy. Results After treatment, in group C, bone pain relief and imaging improved efficacy were better than that in A, B group(P0.05); new bone lesions of group A,group C was less than that of group B(P0.05)，hematologic toxicity 3 groups had no statistically significant differences(P0.05). Conclusion The treatment of radionuclide 89Sr combine local radiotherapy with bone metastases carcinoma of big lesions has better pain relief,could reduce bone metastases, it is an effective and safety measure for bone meta