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Objective:To evaluate the clinical value of CT-guided 125I seeds implantation combining with 89SrCl 2 to relieve pain after failure of external irradiation in patients with bone metastases from prostate cancer. Methods:Clinical data of 48 patients (age 56-85 years) with bone metastases from prostate cancer admitted to General Hospital of the Northern Theater Command from January 2019 to June 2021 were retrospectively analyzed. Patients were treated with 125I seeds implantation combining with 89SrCl 2 (group A) and 89SrCl 2 alone (group B), respectively. Independent-sample t test and repeated measures analysis of variance were used to evaluate the differences of pain level (most severe pain, least pain, mean pain and current pain) scores and bone pain interference scores between 2 groups before and after treatment (before treatment, 3 d, 4 weeks, 8 weeks and 12 weeks after treatment). Prostate specific antigen (PSA), free PSA (fPSA) and alkaline phosphatase (ALP) 12 weeks after treatment of 2 groups were also compared by using independent-sample t test. Results:In group A, a total of 722 seeds were implanted in 39 bone metastases in 23 patients, and the implantation successful rate was 97.44%(38/39). There were 25 patients in group B. In group A, the most severe pain, mean pain and current pain scores decreased with time ( F values: 3.71-22.47, all P<0.05). Except for the scores at 3 d posttreatment, most severe pain, mean pain, and current pain scores at different times showed significant differences with those before treatment (all P<0.05). There were also differences in the most severe pain, mean pain, and current pain scores in group B before and after treatment ( F values: 2.45-2.52, P values: 0.044-0.049), with scores decreasing first (till 8 weeks after treatment) and increasing later. The most severe pain, mean pain, and current pain scores 8 week after treatment were lower than those before treatment (all P<0.05), but all the four scores at 12 weeks were not significantly different from those before treatment ( P values: 0.057-0.693). At 12 weeks after treatment, the differences in the most severe pain, mean pain and current pain scores between 2 groups were statistically significant ( t values: 2.04-3.41, P values: 0.001-0.047). Bone pain interference scores 12 weeks after treatment in group A were higher than those in group B ( t values: 2.04-3.16, P values: 0.022-0.047), and PSA, fPSA and ALP 12 weeks after treatment in group A were significantly lower than those in group B ( t values: 4.38-6.82, P values: 0.012-0.042). Conclusion:CT-guided 125I seeds implantation combined with 89SrCl 2 is feasible and effective for the treatment of bone pain after failed external irradiation in patients with prostate cancer bone metastases, especially for the combination of fulminant pain.
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Cutaneous hemangioma is a kind of benign skin vascular tumor caused by congenital abnormal vascular development. The rays emitted by 90Sr has a good effect on it. Meanwhile, 90Sr application is easy to operate, effective, with less side effects and painless. It is a method worthy of promotion in the treatment of skin hemangioma. This article reviews the application of 90Sr application in cutaneous hemangioma treatment.
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Objective:To investigate the clinical effect of 90Sr application on superficial hemangioma in hair area and its effect on the volume of hair. Methods:A total of 136 pediatric patients (55 males, 81 females, 1-30 months old; 136 lesions) with head hemangioma in the First Affiliated Hospital of Guangxi Medical University between February 2018 and October 2019 were enrolled. They were divided into 3 groups according to the hair density of tumor sites. Group A ( n=63, 3(2, 6) months old, male/female=27/36): the hair in tumor sites was as thick as the surrounding hair. Group B ( n=40, 3(2, 5) months old, male/female=17/23): the hair in tumor sites was thinner than the surrounding area. Group C ( n=33, 3(2, 6) months old, male/female=11/22): there was no hair growth in the tumor sites. All groups were treated with 90Sr application, and the total absorbed dose of each course was 10-30 Gy, which was divided into 8 times. Three to four months after the treatment, the efficacy and adverse reactions were evaluated and the volume of hair was divided into 3 grades according to the hair density of the tumor sites: flourishing, good growth and no growth. If the clinical effect was unsatisfied, a second course of treatment was conducted. Kruskal-Wallis rank sum test or χ 2 test was used for data analysis. Results:The differences of age ( H=0.01), gender ( χ 2=0.92) among group A, group B and group C were not significant (both P>0.05). The total recovery rates of 3 groups after two-course treatment were 88.9%(56/63), 95.0%(38/40) and 93.9%(31/33) respectively ( χ 2=1.49, P>0.05). Besides, the incidences of adverse reactions were 6.3%(4/63), 7.5%(3/40) and 9.1%(3/33) respectively ( χ 2=0.24, P>0.05). Three to four months after treatment, the hair on tumor sites in group A and B was rated as flourishing, 28 children in group C were rated as flourishing, 5 children were rated as good growth, and none of the children showed no growth. Conclusions:The 90Sr application has a good treatment effect on the small superficial hemangioma in the hair area of infants, and the amount of hair in the affected area can be restored to normal after treatment. This treatment is worthy of clinical application.
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Objective To observe the hematological toxicity of 89SrCl2 in patients with multiple bone metastases of malignant tumors,and analyze the related-risk factors.Methods A total of 89 patients (63 males,26 females;age:(62.3±5.2) years) with multiple bone metastases and treated with 89SrCl2 were enrolled.Hematological data at 2 and 4 weeks after treatment with 89SrCl2 were analyzed.Common Terminology Criteria for Adverse Events (CTCAE) v4.03 was used to evaluate the hematological toxicity,and the influencing risk factors were analyzed.Logistic regression analysis was used to analyze the data.Results The incidences of grade Ⅰ-Ⅱ anemia,leukopenia and thrombocytopania at 2 and 4 weeks after treatment were 15.7％(14/89),18.0％(16/89),11.2％(10/89) and 18.0％(16/89),24.7％(22/89),18.0％(16/89),respectively.The incidences of grade Ⅲ-Ⅳ anemia,leukopenia and thrombocytopenia were 2.2％(2/89),0,0 and 2.2％(2/89),2.2％(2/89),3.4％％(3/89),respectively.Logistics multivariate analysis showed that the number of bone metastases and the Hb level before treatment were independent effect factors for hematological toxicity of 89SrCl2,with odds ratio (OR) values of 2.200(95％ CI:1.269-3.841) and 0.961 (95％ CI:0.932-0.991),respectively.Conclusions Serious hematological toxicity after 89SrCl2 treatment is rare.The number of bone metastases and the Hb level before treatment are independent effect factors for hematological toxicity.
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Skeleton is one of the most common metastasis sites of malignant tumor.Bone metastases can cause bone pain,pathologic fractures,spinal cord compression and other bone related events,which seriously affect the quality of life of patients.The treatment modalities of bone metastases are diverse.External beam radiotherapy and 89 Sr are commonly used in the treatment of bone metastases,however,a single treatment cannot achieve satisfactory results.This review summarizes the advances of 89Sr combined with external beam radiotherapy for bone metastases.
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Objective To evaluate the efficacy of 90Sr-90Y applicator treatment for hemangioma by superficial ultrasound.Methods A total of 94 infants with hemangioma were retrospectively analyzed,including 37 males and 57 females (age range:1-12 months,mean =4.5 months).Thickness of hemangioma was measured by superficial ultrasound on the day before 90Sr-90Y applicator treatment,10 d and 3 months after treatment.Paired t test and x2 test were used to analyze data.ROC curve was analyzed to determine the tumor thickness which could be cured by one-cycle of treatment.Results Sixty-two cases were cured,29 cases had partial response and 3 cases had treatment failure.Thickness of hemangioma was (0.38 ±0.28)cm before treatment and (0.16±0.35) cm 3 months post-treatment and the difference was statistically significant (t=7.377,P＜0.05).The treatment effect of 90Sr-90Y applicator was not influenced by gender.According to the site of hemangioma,the curative rates were 20/38 in head & neck,22/33 in chest,20/23 in limbs.Only the difference between the curative rates in head & neck and limbs was statistically significant (x2 =7.478,P＜0.05).The treatment effect of 90Sr-90Y applicator was evaluated by the thickness of hemangioma under the skin at 3 months post-treatment and the area under the ROC was 0.93.The threshold of the thickness of hemangioma which could be cured by one-cycle of treatment was 0.32 cm with the sensitivity of 93.8％ and specificity of 85.5％.Conclusions The 90Sr-90Y applicator had a good treatment effect on pure hemangioma in infants,especially for those located in limbs and torso.The lesion with thickness less than 0.32 cm had a higher chance to be cured by one-cycle of treatment.
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Objective:To evaluate the clinical value of radioactive nuclide strontium chloride (89SrCl2) combined with 99Tc-MDP in treating patients with breast cancer and osseous metastasis. Methods:A total of 80 patients with breast cancer and experiencing bone pain from osseous metastasis were randomly categorized into three groups. 22 patients were treated with 99Tc-MDP (99Tc-MDP group), 30 were treated with 89SrCl2 (89SrCl2 group), and 28 were treated with the combination therapy of 89SrCl2 and 99Tc-MDP (combination group). The analgesic effect, remission of bone metastases, and quality of life of patients in the three groups were observed before and after treatment. Side effect was also monitored. Results:In the combination group, the overall pain relief rate and the increase rate of life quality score were 92.9%(26/28) and 78.6%(22/28), respectively. The combination group was statistically significantly different from the two single-treatment groups (P0.05). Conclusion:The treatment of 89SrCl2 com-bined with 99Tc-MDP can increase the analgesic effect and significantly improve the curative effect without overt side effects in patients with breast cancer and bone metastasis.
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Objective To investigate the clinical efficacy and safety of 90Sr-90Y applicator combined with topical timolol maleate for infantile superficial hemangiomas.Methods A total of 59 infants with hemangiomas were randomly divided into a study group (n=33; ≤3 months,15 cases;＞3 months,18 cases) and a control group (n=26; ≤3 months,10 cases; ＞3 months,16 cases).The study group was treated with 90Sr-90Y applicator combined with timolol maleate solution (0.5％) and the control group was treated with the same dose of 90Sr-90Y applicator combined with saline.Treatment effectiveness was compared between the two groups,and x2 test was used for statistical analysis.Adverse reaction was observed and recorded.Results The effective rate was 18/18,and the cure rates were 14/15 (≤ 3 months) and 16/18 (＞3 months) in the study group.The effective rates were 8/10 (≤3 months) and 11/16 (＞3 months),and the cure rates were 6/10 (≤3 months) and 9/16 (＞3 months) in the control group.Both the effective rate and cure rate of the study group were significantly higher than those of control group (x2 =22.22 and 30.29,≤3 months; x2 =36.69 and 27.31,＞3 months; all P＜0.01).Significant adverse reaction was not found in both groups.Conclusion 90Sr-90Y applicator combined with 0.5％ solution of topical timolol maleate has a very high effective and cure rate for infantile superficial hemangiomas,without significant adverse reaction observed.
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Objective To explore the best way and the security of hypertrophic scar treatment by surgery combined with isotopic 90 Sr-90 Y or triamcinolone acetonide.Methods Hypertrophic scar of rabbit ears were divided into direct treatment group (Group A received 90 Sr-90Y irradiation,Group D received triamcinolone acetonide),two days 90 Sr-90 Y irradiation after surgery repair group (Group B),one week treatment after surgery repair group (Group C received 90Sr-90 Y irradiation,Group E received triamcinolone acetonide),saline injection group (Group F received saline directly,Group G received saline injection after surgical repair one week later),Group H received nothing,and then the histological changes were compared in each group.Results The 90Sr-90 Y exposure groups (Groups A,B,C) and triamcinolone acetonide injection groups (Groups D and E),the number of fibroblasts,collagen fiber surface density,microvessel counts and α-SMA-positive particle optical density values were significantly lower than the saline groups (Groups F,G) and blank control group.The most obvious group was Group B; Groups A,C,D,and E were not statistically significant.The number of melanoma cells of 90Sr-90Y exposure group (Groups A,B,and C) was significantly lower than other groups,with statistically significant difference.Atypical cells were not found in 90Sr-90 Y applicator exposure group.Conclusions Isotope 90 Sr-90 Y and triamcinolone acetonide inhibits the proliferation of the rabbit ear hypertrophic scar,the scar tissue fibrosis is reduced significantly,but there is no significant difference between the two effects.Early isotope 90 Sr-90 Y intervention on hypertrophic scar can achieve better results.Hypertrophic scar by isotope 90 Sr-90 Y radiation is easy to cause depigmentation,but generally does not cause cancer.
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Objective To investigate the clinical efficacy of 90Sr-90Y applicator combined with propranolol (inderal) treatment for infants with large areas of cutaneous hemangiomas.Methods Thirty-nine infants with large areas of cutaneous hemangiomas were randomly divided into two groups:study group (n =18) treated with 90Sr-90Y applicator in conjunction with propranolol,and control group (n =21) treated by 90Sr-90Y applicator only.The results of curative effects between the two groups were analyzed using rank sum test and x2 test.Results The cure rate,remission rate and effective rate for the study group were 44.4％(8/18),55.6 ％ (10/18) and 100.0％ (18/18),respectively,and the corresponding rates for the control group were 14.3％ (3/21),52.4％ (11/21) and 66.7％ (14/21),respectively.The effective rate in the study group was significantly higher than that in the control group (Z =-2.861,P ＜ 0.05).The adverse reaction rates in the study and control groups were 66.7％ (12/18) and 19.0％ (4/21 ;x2 =9.084,P ＜0.05),respectively.Conclusion Combined propranolol with 90Sr-90Y treatment for large infantile hemangiomas is clinically effective,but its side effects should be closely monitored.
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Objective To evaluate the palliative effect on pain relief in patients with multiple bone metastases treated with 89SrCl2 together with Sodium Ibandronate,Sodium Ibandronate alone and 89SrCl2 alone. Methods Eighty-four patients with bone pain secondary to bone metastases were divided into three groups. Thirty patients were treated with combined 89SrCl2 and Sodium Ibandronate,26 with 89SrCl2 alone and 28 with Sodium Ibandronate alone. The x2 test was used in data analysis. Results The overall palliative pain relief rate in the combined treatment group was 96.6 % (29/30). For the groups using Sodium Ibandronate or 89SrCl2 only,the palliative rates were 71.4% (20/28) and 73.1% (19/26),respectively. There are statistically significant differences between the combined treatment group and the other 2 groups with single treatment modalities in the overall palliative pain relief rate (x2 = 7.497 ),in terms of improvement in (1) whole body Karnofsky performance status (KPS) score (80.0% (24/30) vs 50.0% (14/28)/53.8% (14/26),x2 =35.476) and (2) focal palliative rate (47.6% (50/105) vs 11.2% (11/98)/22.2% (20/90),x2 =6. 564,all P ＜ 0. 05 ). Conclusions Combined treatment with 89 SrCl2 and Sodium Ibandronate is more effective than single treatment modalities to relieve bone pain seccondary to multiple bone metastases.
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Objective To evaluate the therapeutic effect of 89 Sr internal radiotherapy on multiple-bone metastasis of cancer. Methods Forty-nine cancer patients with multiple-bone metastasis received 89 Sr internal radiotherapy. The pain control effect, life quality improvement, change in levels of blood calcium and serum alkaline phosphatase (ALP), and side effects were analyzed respectively. Results The total effective rate of pain control was 77.6 %. The life quality was improved obviously. The levels of blood calcium and ALP were decreased. No obvious side effects were found during the treatment. Conclusion 89 Sr internal radiotherapy had a good therapeutic effect on multiple-bone metastasis of cancer.