Evaluation Of 89 Strontium (89Sr) And Zoledronic Acid On Bone Metastasis Of Prostate Cancer

Objective:To explore the effect of ⁸⁹strontium?89Sr?and zoledronic acid on bone metastasis of prostate cancer.Methods:Retrospective analysis from Nanchang University First Affiliated Hospital 88 cases of advanced prostate cancer patients from January 2014 to June 2016.After admission,complete rectal examination?DRE?,PSA test,transrectal ultrasonography?TRUS?,and confirmed by rectal prostate biopsy for prostate cancer,bone scan with single or multiple parts of bone metastasis.88 cases were divided into three groups?group A,28 cases,group B,30 cases?:the data included patient age?group A 64.24 ± 7.32,group B 63.82 ± 8.43,group C 63.12±7.43?;Gleason score??6 points: 4 / 28,5 / 30,,5/30;7 points: 2 / 28,3 / 30,2/30;?8 points: 22/28,22/30,23/30?;serum TPSA?<10 ng / ml: 1/28,1/30,0/30;10-20 ng / ml: 4/28,5/30,5/30;> 20 ng / ml: 23/28,24/30,25/30?.Treatment: group A were treated with strontium chloride [89SrCl2] 148 MBq /?4 mci?intravenously;group B were 4 mg zoledronic acid + 0.9% 100 ml saline intravenous infusion,once a month,March a course of treatment;88 patients were required to use endocrine blocking androgen therapy.The number of bone metastases,the pain of the bone pain,the pain index after treatment,the changes of blood and liver function were evaluated according to the outpatient follow-up.Measurement data between different groups using the sample t test,the count data using X2 test,P <0.05 for the difference was statistically significant.Results:?1?The number of bone metastases treatment efficiency:group A?85.7%?was higher than group B?60%?,which was statistically significant?P =0.029<0.05?;group A?85.7%?was higher than group C?50%?,which was statistically significant?P=0.004<0.05?;group B?60%?was higher than group C?50%?,which was not statistically significant?P=0.436>0.05?.?2?Bone pain response rate: group A?92.9%?higher than group B?70%?,which was statistically significant?P = 0.026 <0.05?;group A?92.9%?was higher than group C?66.7%?,which was statistically significant?P=0.014<0.05?;group B?70%?was higher than group C?66.7%?,which was not statistically significant?P=0.781>0.05?.?3?Post-treatment pain index:No response rate:group A?3.6%?was lower than group B?6.7%?,which was not statistically significant?P=0.595>0.05?;group A?3.6%?was lower than group C?13.3%?,which was not statistically significant?P=0.186>0.05?;.group B?6.7%?was lower than group C?13.3%?,which was not statistically significant?P=0.389>0.05?.Moderate reaction rate:group A?17.9%?was lower than group B?26.7%?,which was not statistically significant?P=0.421>0.05?;group A?17.9%?was lower than group C?53.3%?,which was statistically significant?P=0.005<0.05?;.group B?26.7%?was lower than group C?53.3%?,which was statistically significant?P=0.035<0.05?.Good response rate:group A?32.1%?was lower than group B?46.7%?,which was not statistically significant?P=0.259>0.05?;group A?32.1%?was higher than group C?26.7%?,which was not statistically significant?P=0.647>0.05?;group B?46.7%?was higher than group C?26.7%?,which was not statistically significant?P=0.108>0.05?..The reaction is very good rate: group A?46.4%?higher than group B?20%?,which was statistically significant?P=0.032<0.05?;group A?46.4%?was higher than group C?6.7%?,which was statistically significant?P=0.001<0.05?;group B?20%?was higher than group C?6.7%?,which was not statistically significant?P=0.129>0.05?.?4?Liver function before and after treatment no significant changes,⁸⁹Sr common adverse reactions are bone marrow suppression?50%?,with mild myelosuppression.Common side effects of zoledronic acid are digestive system symptoms?13.3%?.Blood system adverse events:Grade 1: group A?28.6%?higher than group B?6.7%?,which was statistically significant?P = 0.027 <0.05?;group A?28.6%?was higher than group C?3.3%?,which was statistically significant?P=0.008<0.05?;group B?6.7%?was higher than group C?3.3%?,which was not statistically significant?P=0.554>0.05?.Grade 2: group A?14.3%?higher than group B?3.3%?,which was not statistically significant?P=0.138>0.05?;group A?14.3%?was higher than group C?0%?,which was statistically significant?P=0.032<0.05?;group B?3.3%?was higher than group C?0%?,which was not statistically significant?P=0.313>0.05?.Grade 3: group A?7.14%?higher than group B?0%?,which was not statistically significant?P=0.136>0.05?;group A?7.14%?higher than group C?0%?,which was not statistically significant?P=0.136>0.05?;group B?0%?and group C?0%?can not be compared.Conclusion:?1?Prostate cancer bone metastases decreased in number: ⁸⁹Sr combined with endocrine effect was significantly better than zoledronic acid combined with endocrine,single endocrine efficacy.?2?Bone pain response rate: ⁸⁹Sr combined with endocrine effect was significantly better than zoledronic acid combined with endocrine,single endocrine efficacy.?3?Post-treatment pain index:the reaction rate is very good,⁸⁹Sr combined with endocrine effect was significantly better than zoledronic acid combined with endocrine,single endocrine efficacy;No response rate,moderate reaction rate,good response rate was no significant difference.?4?Adverse events in the blood system 1: ⁸⁹Sr more common than zoledronic acid;89Sr adverse reactions than zoledronic acid rare.Liver function before and after treatment no significant changes.