Radionuclide therapy of multiple bone metastases and bone pain

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Almost any cancer can be transferred to the skeletal system, autopsy confirmed that 30%-70% patients with malignant tumors with bone metasta


Almost any cancer can be transferred to the skeletal system, autopsy confirmed that 30%-70% patients with malignant tumors with bone metastasis. Lung cancer, breast cancer, prostate cancer patients, about 7085% patients with bone metastasis. Data show that more than 70% of patients with metastatic bone cancer has severe bone pain, so that patients and their families suffer physically and mentally. In the treatment of advanced malignant tumor, intractable pain is one of the medical oncologists, the most difficult problem. Therefore, many efforts are devoted to the completion of analgesia or to improve the quality of life in patients with advanced cancer. At present, the methods of improving bone pain include: non narcotic analgesic drugs, narcotic analgesics, non steroidal anti-inflammatory drugs, hormones, chemotherapy and external radiation therapy, etc.. Radiotherapy is commonly used in the local lesions, is incapable of action on systemic extensive bone metastasis; chemotherapy and hormone is effective in the early stages, but can appear serious adverse reactions or lead to treatment failure; some other analgesic drug addiction and pain may, in a relatively short time, after stopping the pain "comeback".

Application of radionuclide bone pain caused by the treatment of metastatic bone cancer began in the last century in 40s, and has received extensive attention in mid 80s after. This is because the radionuclide therapy method has the advantages of simple treatment, curative effect and long duration of action, no trauma, little side effects, without hospitalization and good treatment effect, so it has become a new treatment method. At present, domestic and foreign often used for the treatment of malignant bone metastasis of radionuclide 89Sr, 153Sm and 186Re. After intravenous injection, these radioactive compounds (or complex) with the blood can be more concentrated in the lesions, the part of the urinary tract excretion. The concentration of the beta ray released by the radionuclide decay process can kill the tumor cells in the metastatic site, so as to achieve the purpose of relieving pain, inhibiting or killing tumor cells. A large number of clinical studies show that the preparation of relief of bone pain rate was 80% - 90%, average time to pain relief in two weeks, the duration of the response by different preparations for 5 weeks in june. At the same time, after the treatment of patients, systemic bone imaging was also observed in some patients with bone metastasis narrowed or disappeared. Since 89SrCl2 (strontium chloride) and 153Sm-EDTMP (ethylenediamine tetramethylene phosphate) to obtain FDA (U.S. Food and Drug Administration) approval is widely used in the clinical practice, provides an ideal method for the treatment of radiotherapy and chemotherapy failure of bone metastatic cancer, has played a positive role in relieving the patient's pain, bone metastasis to improve the quality of life and prolong the survival period. Therefore, the characteristics of internal radiation therapy: 1 noninvasive no surgery, no hospitalization, outpatient treatment, only intravenous injection can; 2 oriented drugs reach metastasis, metastatic bone and the radioactivity ratio of normal bone can be as high as 25/1; 3 long-term injection can be maintained in January 1 (153Sm-EDTMP) or 3-6 (89SrCl2); 4 micro toxicity compared with other treatments, the side effect of treatment is the white blood cell count and platelet count may have decreased, but quickly recovered, bone marrow toxicity is much lower than that of radiotherapy and chemotherapy; 5 economy can reduce about 40% comprehensive medical expenses.

Department of nuclear medicine, Southwest Hospital, took the lead in since the start of 153Sm-EDTMP treatment of multiple bone metastatic carcinoma in Chongqing city since 1991, there have been more than 2000 cases after treatment, in remission patients pain, increase patient appetite, improve sleep quality, improve the activity ability and received satisfactory results, most patient survival was significantly longer than that found at the same time with and other similar but not for the treatment of patients received positive attention and welcome the patients and their families, and has accumulated rich clinical experience. We look forward to meeting the wishes of the families of patients, for patients to relieve the pain of the body and mind, establish confidence in life, live a high quality of life.

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