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目的探讨~(89)Sr内照射治疗骨转移癌的临床疗效和不良反应。方法选取2011年1月至2015年1月间四川省资阳市第一人民医院治疗的80例骨转移癌,均采用放射性核素~(89)Sr经静脉注射内照射治疗。所有患者治疗结束后均随访2年,观察患者治疗后的临床效果、止痛效果和治疗后对血象的影响。结果80例患者经~(89)Sr内照射治疗后,显效28例(35.0%),有效39例(48.8%),总有效率为83.8%,显效与无效比较,差异有统计学意义(x~2=7.33,P=0.01);有效与无效比较,差异均有统计学意义(x~2=19.14,P<0.01)。乳腺癌骨转移的止痛有效率为96.3%,肺癌骨转移的止痛有效率为70.6%,鼻咽癌骨转移的止痛有效率为75.0%,前列腺癌骨转移的止痛有效率为100.0%,甲状腺癌骨转移的止痛有效率为80.0%,直肠癌骨转移的止痛有效率为100.0%,子宫癌骨转移的止痛有效率为0,胃癌骨转移的止痛有效率为0,食管癌骨转移的止痛有效率为100.0%。经内照射治疗后,27例患者发生不同程度的白细胞分度(33.8%);27例患者发生不同程度的血小板分度(33.8%),所有患者经升血象治疗后白细胞和血小板恢复正常。结论发生广泛性骨转移癌的患者采用~(89)Sr行静脉注射内照射治疗,止痛效果良好,不良反应少,值得临床推广应用。
Objective To investigate the clinical efficacy and adverse reactions of ~ (89) Sr irradiation in the treatment of bone metastases. Methods 80 cases of metastatic bone cancer from January 2011 to January 2015 in Ziyang First People’s Hospital of Sichuan Province were treated with radionuclide ~ (89) Sr by intravenous injection. All patients were followed up for 2 years after the end of treatment to observe the clinical effect, analgesic effect and the effect on the blood after treatment. Results Eighty patients (35.0%) were effective after irradiation with 89 (89) Sr, 39 patients (48.8%) were effective and the total effective rate was 83.8%. The difference was statistically significant (x ~ 2 = 7.33, P = 0.01). There were significant differences between effective and ineffective (x ~ 2 = 19.14, P <0.01). Analgesic effective rate of breast cancer bone metastasis was 96.3%, analgesic effective rate of bone metastasis of lung cancer was 70.6%, analgesic effective rate of bone metastasis of nasopharyngeal carcinoma was 75.0%, effective rate of analgesic pain of bone metastasis of prostate cancer was 100.0%, thyroid cancer The analgesic effective rate of bone metastasis was 80.0%, the analgesic effective rate of bone metastasis of rectal cancer was 100.0%, the analgesic effective rate of uterine cancer bone metastasis was 0, the analgesic effective rate of bone metastasis of gastric cancer was 0, the analgesic of esophageal bone metastasis Efficiency is 100.0%. After internal irradiation, 27 patients had varying degrees of leukocyte differentiation (33.8%); 27 patients had varying degrees of platelet index (33.8%), all patients returned to normal after leukocyte and platelet therapy. Conclusions Patients with extensive bone metastases are treated by intravenous injection of ~ (89) Sr. The analgesic effect is good with few adverse reactions, which is worthy of clinical application.