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The study objective was to investigate and compare the effectiveness of different radiopharmaceuticalsin the treatment of metastatic bone disease.Cancer patients (n = 150, average age (55 ± 11.6) years, 95 females, 55 males) having gotvarious primary tumors and metastatic bone disease were given medical treatment at the Department of NuclearMedicine of the National Institute of Cancer. The 153Sm, 32Р, and 89Sr radiopharmaceutical agents produced by the«Radiopreparats» enterprise (Republic of Uzbekistan) and Radioisotope Centre Polatom (National Centre for NuclearResearch, Poland) were administered to the patients. There were cases of breast cancer (n = 75), prostate cancer(n = 45), lung cancer (n = 10), kidney cancer (n = 4), cervical cancer (n = 5), and rectosigmoid cancer (n = 11) amongthe treated subjects. In 135 patients (90 %) the bone metastases were detected by osteoscintigraphy with 99мTc- mo-nodiphosphonate. In 15 cases the diagnosis of metastatic bone disease was verified by other radiology methods.The pain intensity rating scale (LACOMED) was used to assay the analgesic effect of various radiopharma-ceuticals in metastatic bone disease. Results of treatment with 32P, 89Sr, and 153Sm were included in a comparativeanalysis procedure. It was established that the level of pain syndrome ranged from 7-8 points on the LACOMED scalebefore treatment. Upon administration of radionuclide therapy the level of pain was reduced down to 3-5 points,namely with 32P therapy it has decreased by 30.7 %, with 89Sr by 33.2 %, and with 153Sm by 41.5 % respectively. Timepattern of 153Sm analgesic effectiveness was studied depending on the number of treatment sessions. The best valueof analgesic effect of 153Sm was registered after the first treatment session with a tendency to decrease after the sec-ond and significantly lower analgesic effects after the third session. Tolerance of 153Sm was rated on the CTCNCA (v)4.3 scale. The best tolerance was peculiar to 153Sm corresponding to the «good» level according to a point assess-ment. When using 89Sr the drug tolerance was lower, not requiring however the drug discontinuation. The 32P radio-pharmaceutical featured the lowest tolerance approaching the «satisfactory» rating. In 11 patients upon that theside effects were found significantly impairing the patient's status, accordingly some extra measures were required.No decision to cancel the drug administration was made.Radionuclide therapy with 153Sm-oxabiphor agent can be used in the complex treatment of metastat-ic bone disease in cancer patients having got tumors of different localization. 153Sm-oxabiphor is the most effectiveand best tolerable radiopharmaceutical agent in the pain treatment in metastatic bone disease in comparison with32P and 89Sr preparations (р0.05).Meta roboty – doslidyty ta porivniaty efektyvnist' riznykh radiofarmpreparativ u likuvanni metastatychnogourazhennia kistok. Materialy i metody. U viddilenni iadernoï medytsyny Natsional'nogo instytutu raku prolikovano 150 patsiientiv(95 zhinok, 55 cholovikiv; seredniĭ vik – (55 ± 11,6) rokiv) z riznymy pervynnymy pukhlynamy i metastatychnymurazhenniam kistok za dopomogoiu 153Sm, 32R, 89Sr vyrobnytstva pidpryiemstva «Radiopreparaty» Respubliky Uzbe-kystan ta firmy Polatom (Pol'shcha). Sered prolikovanykh – patsiienty z rakom grudnoï zalozy (n = 75), pe-redmikhurovoï zalozy (n = 45), legeni (n = 10), nyrky (n = 4), shyĭky matky (n = 5) i rektosygmoïdal'nogo kutatovstogo kyshkivnyka (n = 11). U 135 patsiientiv (90 %) naiavnist' kistkovykh metastaziv vyznacheno za dopomogoiuosteostsyntygrafiï z 99mTs-monodyfosfonatom. U 15 patsiientiv diagnoz kistkovogo urazhennia veryfikovanoinshymy metodamy promenevoï diagnostyky.Rezul'taty. Provedeno doslidzhennia zneboliuval'nogo vplyvu riznykh radiofarmpreparativ pry metastatych-nomu urazhenni kistok za shkaloiu otsinky intensyvnosti boliu (LAKOMED). U porivnial'nyĭ analiz vkliucheno re-zul'taty likuvannia 32R, 89Sr ta 153Sm. Vstanovleno, shcho do likuvannia riven' bol'ovogo syndromu kolyvavsia v me-zhakh 7–8 baliv za shkaloiu LAKOMED. Pid vplyvom radionuklidnoï terapiï vidmicheno znyzhennia rivnia boliu do3–5 baliv, a same pry terapiï 32R riven' bol'ovogo syndromu znyzyvsia na 30,7 %, pry vykorystanni 89Sr – na33,2 %, a pry likuvanni 153Sm – na 41,5 %. Vyvcheno dynamiku protybol'ovoï efektyvnosti 153Sm zalezhno vidkil'kosti kursiv terapiï. Naĭkrashchyĭ pokaznyk protybol'ovogo vplyvu 153Sm vidmicheno pislia pershogo kursulikuvannia z tendentsiieiu do znyzhennia pislia drugogo i dostovirno nyzhchoiu protybol'ovoiu diieiu pislia tret'ogokursu. Perenosymist' 153Sm otsiniuvaly za shkaloiu CTCNCA (v) 4.3. Za bal'noiu otsinkoiu naĭkrashcha perenosymist'kharakterna dlia 153Sm i vidpovidaie rivniu «khorosha» za shkaloiu CTCNCA(v)4.3. Pry vykorystanni 89Sr pereno-symist' preparatu bula nyzhchoiu, ale ne potrebuvala vidminy preparatu. Naĭgirsha perenosymist' bula vlas-tyva dlia 32R i nablyzhalas' do «zadovil'noï». Pry ts'omu u 11 khvorykh vidmichaly pobichni efekty, iaki znachnovplyvaly na stan khvorogo i potrebuvaly dodatkovykh zakhodiv. Rishennia pro podal'shu vidminu preparatu nepryĭmalos'.Vysnovky. Radionuklidna terapiia z 153Sm-oksabiforom mozhe buty zastosovana v kompleksnomu likuvanni me-tastatychnogo urazhennia kistkovoï systemy pry zloiakisnykh pukhlynakh riznoï lokalizatsiï. Naĭbil'sh efektyvnymporivniano z 32R i 89Sr u likuvanni kistkovykh metastaziv za zneboliuval'noiu diieiu ta perenosymistiu preparatu ie 153Sm-oksabifor (r0,05). |
