Clinical Application Of ⁸⁹Sr To Bone Metastases Of Malignant Tumor

In these years, more and more patients are found with bone metastases of malignant tumor. They are all suffered form severe bone pains, hypercalcemia, pathological fracture, damage of nerve system, limitation of activity and other syndromes caused by metastases of bones. The life qualities of these people are affected greatly. But, there is still no effective method to cure bone metastases. Surgery, medical treatment, radiotherapy, chemo- therapy and radionuclide therapy are all alleviative treatments to prolong the lives of patients, palliate their pains and improve patients'life.Bone–seeking radionuclide therapy is one of the most proper methods chosen by doctors and patients because of its easy usage and high performance in alleviate pains. Strontium-89 (⁸⁹Sr) is one of them. It's the kind of radionuclide that only emitsβrays with a half-life of 50.6 days. The chemical property of strontium-89 is similar to calcium, so it can accumulates in osteoblast and emitsβ rays to kill tumor cells after intravenous infusion. According to the literature,it has the best performance in cancer of breast and prostate. The side effect of strontium-89 is slight bone marrow depression (in platelet and leukocyte). But the level of blood cell could recover to the previous level in a few weeks without severe damage.Recently, a lot of research was made on application of strontium-89 to therapy of bone metastases. The dosage, the depression of bone marrow, the changes of CD4/CD8 cell, the pharmacokinetic property and the combination application with other methods are all well studied. But not so much work was made on the changes of tumor markers.Objective: The purpose of this study is to evaluate clinical effects of strontium-89 in palliating pains of bone metastases (especially in bone metastases of lung cancer, breast cancer and prostate cancer). The bone marrow depression of platelet and leukocyte and changes of tumor markers such as PSA and CA-153 were also observed.Methods: The primary tumors of 31 patients were all confirmed by pathology and metastases of bones were found by SPECT or X-ray CT. All patients had bone pains, some of who have limitation of activity. Radiotherapy or chemotherapy has been stopped for over 2 weeks. Liver and kidney function were normal. WBC> 3.5×109/L, PLT> 80.0×109/L, RBC> 3.0×1012/L. Patients were divided into 4 groups (lung cancer, 6 male; prostate cancer, 11 male; breast cancer, 12 female; other tumors, 1 male,1 female) by pathology of primary tumor. Changes of WBC (white blood cell), PLT (platelet), VAS scores, metastases lesions of bones, Karnofsky scores, PSA (for prostate cancer) and CA-153 (for breast cancer) levels were observed (before the therapy and 6 weeks after the therapy). All the data were analyzed by SPSS 16.0.Results: No evident change was found in the level of WBC. A slightly decrease of PLT was found. The VAS scores and Karnofsky scores increased after the therapy. PSA of prostate cancer group and CA-153 of breast cancer group decreased. More metastases lesions were found in bones after therapy.Conclusions: Radionuclide strontium-89 is effective in treating bone pains from metastases and could improve patients'life qualities. It can restrain metastases of some tumor, but is unable to cure them. Decreasing of PLT were found in some of the patients, but recoverd to normal level in a few months, so strontium-89 is still a reliable drug.