246 KB14 KB199220251998Bleckmann, ChristianBohuslavizki, Karl H.Clausen, MalteKlutmann, SusanneKroeger, SabineMester, JanosSchulte, Ulrikeletnik:32številka:4str. 367-371ISSN:1318-2099COBISSID_HOST:8141273URN:URN:NBN:SI:doc-TPITM0Z8enCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)Bone neoplasmsPainPalliative careProstatic neoplasmsRadioisotopesRadionuclide imagingRheniumSecondaryTherapyPalliation of painful osseous metastases in patients with prostate cancer usig Re-186-HEDP| Paliativno zdravljenje bolečin kostnih metastaz pri bolnikih s karcinomom prostate z uporabo Re-186-HEDP|The skeleton is the second most common site of metastases in patients with prostate cancer. While curative means are strongly limited in these patients their life expectancy may be still several years. Therefore, it is essential to improve quality of life of these patients. Sufficient therapy of painful osseous metastases is the main goal in patients with advanced prostate cancer.The primary approach to relieve bone pain is the application of peripheral or central analgesics. In case of bone pain due to a single metastatic site local external beam radiation may provide pain relief in a reasonable amount of patients. In case of painful multilocular metastases systemic application of radiopharmaceuticals may irradiate bone metastases while normal tissue is spared from beta-irradiation. Due to their physical characteristics Re-186 and Sm-153 have been developed for palliative treatmentof metastatic bone pain. The response rate amounts to about 70-80% ofall patients treated. Pain relief may last for 1-6 months. Due toits low grade toxicity which is mainly dominated by a transient thrombocytopenia therapy can be repeated. However, Re-186-HEDP therapy does not alter life expectancySkelet je drugo najbolj pogosto mesto metastaziranja karcinoma prostate. Čeprav so ozdravitev pri bolnikih s tako razširjeno boleznijo silno redke, pa je pričakovana življenjska doba bolnikov vendarle nekaj let. Zato je pomembna njihova kakovost življenja. Ustrezno bolečinsko zdravljenje je še vedno najpomembnejši cilj pri obravnavi bolnikov z napredovalo boleznijo karcinoma prostate. Bolečine skušamo najprej umiriti s perifernimi in centralnimi analgetiki. ob bolečinah zaradi solitarne kostne metastaze znatnemu številu bolnikov pomaga teleradioterapevtično obsevanje. V primeru bolečih multiplih kostnih metastaz, pa je učinkovito obsevanje le-teh z intravensko aplikaciranimi radiofarmacevtiki, ki so sevalci žarkov beta, zdrava tkiva pa prejmejo zanemarljivo obsevalno dozo. Zaradi svojih fizikalnih lastnosti (kratek razpolovni čas in možnosti spremljanja kopičenja radiofarmaka z gama kamero) sta za takšno zdravljenje primerna Re-153 in Sm-153. Odgovor na zdravljenje dosežemo v 70-80%. Analgetski učinek se pokaze 1-6 mesecev po zdravljenju. Zaradi blagih stranskih učinkov, ki se kažejo predvsem kot prehodna trombopenija, lahko zdravljenje ponovimo. Do sedaj pa niso dokazali, da bi zdravljenje z Re-186-HEDP lahko vplivalo na dolžino preživetjaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana