The Efficacy Analysis And Systematic Review Of Strontium Chloride In The Treatment Of Bone Metastatic Lesions

Part I The Efficacy Analysis of Strontium Chloride in The Treatment for Bone Metastatic from TumorsObjective:To evaluate the efficacy and safety of strontium chloride in the treatment for bone metastases by retrospective analysis.Materials and methods:69 cases of bone metastases who treated by strontium chloride were obtained from the Nuclear Medicine Department of Affiliated Hospital of North Sichuan Medical College from February 2015 to December 2017,including 36 cases of prostate cancer,23 cases of lung cancer and 10 cases of breast cancer.The pain score,the number of the lesions,the platelets count and leukocytes count in the peripheral blood was evaluated and recorded before and after 3 months of strontium chloride treatment.Besides,The pain relief response was evaluated after 3 months of treatment.Results:1.The pain scores of patients with bone metastases before treatment were 5.981±0.2913,the pain scores were 3.808±0.2958 after 3 months of strontium chloride treatment.The paired T test showed that the pain score of the patients was significantly lower than that before the treatment?P<0.05?.2.After 3 months of strontium chloride treatment,the bone pain relief reactions were:CR 10 cases,PR 26 cases,MR 15 cases,NR 18 cases.The total effective rate of strontium chloride was 73.9%,the effective rate of prostate cancer was 80.56%,the effective rate of lung cancer group was65.2%,and the effective rate of breast cancer was 70%.3.The number of lesions of the patients before treatment was 10.26±0.72,the number of lesions was 9.03±0.61 after 3 months of strontium chloride treatment.The paired T test showed that there was no significant difference?P>0.05?.According to different tumor types,The number of lesions of the prostate cancer patients before treatment was 11.22±1.98,the number of lesions was 8.42±0.89 after 3 months of strontium chloride treatment.The paired T test showed that the lesions of the patients was significantly decreased than that before the treatment?P<0.05?.4.The platelets count of the patients before treatment was?190.8±5.296?×10⁹/L,the platelets count was?182.2±4.786?×10⁹/L after 3 months of strontium chloride treatment.The paired T test showed that there was no significant difference?P>0.05?.The leucocyte counts of the patients before treatment was?6.892±0.1810?×10⁹/L,the leucocyte counts was?6.594±0.1120?×10⁹/L after 3 months of strontium chloride treatment.The paired T test showed that there was no significant difference?P>0.05?.Conclusion:1.The treatment of strontium chloride could significantly reduce pain scores in cancer patients.2.The total effective rate of strontium chloride was 73.9%,the effective rate of prostate cancer was 80.56%,the effective rate of lung cancer group was 65.2%,and the effective rate of breast cancer was 70%.3.The treatment of strontium chloride could not significantly reduce the number of lesions of bone metastases in lung cancer and breast cancer,But it could significantly reduce the number of bone metastases in prostate cancer.4.Strontium chloride has no significant effect on the number of platelets and white blood cells in patients with bone metastases.No other serious adverse reactions were observed.Part II The Systematic Review of Strontium Chloride in The Treatment for Bone Metastatic from Tumors.Objective:To systemically review the efficacy and safety of strontium chloride for bone metastases from Tumors.Methods:The literature included criteria:?1?randomized controlled trials,case-control trials,and observational studies;?2?the subjects were patients with clinically confirmed prostate and breast cancer with bone metastases;?3?intervention measures were treated with strontium chloride in the experimental group;and placebo,radiotherapy,or other radionuclides were used in the control group.PubMed,The Cochrane Library,EMbase,VIP,CBM,CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials?RCTs?about strontium chloride for bone metastases from prostate cancer from inception to November 2016.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies,then,meta-analysis was performed by using RevMan 5.3 software.Results:1.The results of meta-analysis showed that strontium chloride was superior to placebo in the rate of pain relief in patients with prostate cancer[RR=1.79,95%CI?1.35,2.37?,P<0.0001];strontium chloride was superior to radiotherapy in the rate of pain relief[RR=1.26,95%CI?1.09,1.46?,P=0.001];There was no significant difference in the rate of pain relief between strontium chloride and ¹⁵³Sm-EDTMP[RR=0.97,95%CI?0.84,1.12?,P=0.66].The results of meta-analysis showed there was no significant difference in the rate of pain relief between strontium chloride and control group in patients with breast cancer[RR=0.95,95%CI?0.81,1.10?,P=0.446].2.The results of meta-analysis showed that strontium chloride was superior to placebo in the rate of lesions control in patients with prostate cancer[RR=1.51,95%CI?1.06,2.41?,P=0.02].One studies reported the control of strontium chloride on bone metastases in patients with breast cancer.The results showed that there was no significant difference in the rate of lesions control between strontium chloride and control group.3.The results of meta-analysis showed that there was no significant difference in overall survival between strontium chloride and placebo[RR=0.87,95%CI?0.64,1.18?,P=0.37].4.The results of meta-analysis showed that strontium chloride was more likely to cause slight leucopenia[Peto OR=5.02,95%CI?1.49,16.95?,P=0.009]and thrombocytopenia[Peto OR=2.61,95%CI?1.04,6.57?,P=0.04].Conclusion:1.The rate of bone pain relief:strontium chloride was superior to placebo and radiotherapy in patients with prostate cancer,there was no significant difference between strontium chloride and ¹⁵³Sm-EDTMP.There was no significant difference between strontium chloride and other treatment methods in breast cancer.2.Lesion control rate:strontium chloride was superior to placebo in patients with prostate cancer prostate cancer.There was no significant difference between strontium chloride and other treatment methods in breast cancer.3.There was no significant difference in overall survival between strontium chloride and placebo.4.Strontium chloride was more likely to cause slight leucopenia and thrombocytopenia.