锶89有用过的请求分享一下～父亲肺腺癌骨转考虑锶89

荷花池荒岛 发表于 2017-3-29 11:55
https://www.ptt.cc/bbs/Anti-Cancer/M.1224038277.A.E59.html

作者biwayg (亞力有氧G)

其实也就是说这个只是解决疼痛的问题的选择之一，基本没有治疗骨转的作用。

康来 发表于 2017-3-29 13:23
其实也就是说这个只是解决疼痛的问题的选择之一，基本没有治疗骨转的作用。

Use of Strontium-89 in Metastatic Cancer: US and UK Experience


Review Article | September 30, 1994 | Oncology Journal
By Arthur T. Porter, MD, MBA
The utility of strontium-89 (Sr-89) in the treatment of advanced metastatic prostate cancer has been examined in numerous clinical trials. Early phase II efficacy studies demonstrated that the majority of Sr-89-treated patients experienced a decrease in bone pain and analgesia requirements, with overall response rates of 75% to 80%. Toxicity was mainly hematological and clinically insignificant, suggesting that 40 mCi/kg (1.5 MBq/kg) is an optimal palliative Sr-89 dose. A subsequent study verified that the observed clinical response is due to radioactive strontium and is not a chemical effect. Two more recent phase III studies have extended these early results. The TransCanadian study showed that concomitant Sr-89 significantly reduced the appearance of new painful metastases, analgesic requirements, and serum levels of tumor markers compared with radiotherapy alone. Overall, these studies support Sr-89 as an effective systemic radiopharmaceutical for the palliation of bony metastases.

http://www.cancernetwork.com/onc ... s-and-uk-experience

Strontium-89 chloride Side Effects
https://www.drugs.com/sfx/strontium-89-chloride-side-effects.html

Applies to strontium-89 chloride: injectable, solution

Along with its needed effects, strontium-89 chloride may cause some unwanted effects. When strontium chloride Sr 89 is used at recommended doses, side effects usually are rare. However, blood problems, such as a decrease in the number of white blood cells or platelets, may occur in some patients.

Major Side Effects
If any of the following side effects occur while taking strontium-89 chloride, check with your doctor immediately:

Rare
Black, tarry stools
blood in urine or stools
cough or hoarseness
fever or chills
lower back or side pain
painful or difficult urination
pinpoint red spots on skin
unusual bleeding or bruising
Minor Side Effects
Some strontium-89 chloride side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

• Flushing
• increase in bone pain
  

It is possible that some side effects of strontium-89 chloride may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

氯化锶[89Sr]注射液
http://yao.dxy.com/drug/70645.htm


【药品名称】
通用名：氯化锶[89Sr]注射液
商品名：思通宁

【生产企业】
安盛科兴药业有限公司

【适应症】
本品为转移癌性骨痛的治疗剂，主要用于前列腺癌、乳腺癌等晚期恶性肿瘤继发骨转移所致骨痛的缓解，是转移癌性骨痛止痛的一种疗法。

【规格】
氯化锶[89 Sr]150MBq(4mCi)/4mL(瓶)
氯化锶43.6—90.4mg/4mL(瓶)
【用法用量】
用法：开封后3分钟内将药品一次性缓慢静脉注射入病人体内，不需稀释。
用量：1.48MBq/Kg(40μCi/kg)或92.5MBq-137MBq/人(2.5mCi-4.0mCi/人)

【不良反应】
有轻度的骨髓抑制表现，治疗开始的一周内出现疼痛加剧。

【禁忌】
妊娠、哺乳期妇女、儿童患者禁用；
放化疗后造血机能已经损害的患者禁用(血小板≤8.0×1010/L，白细胞≤3.5×109/L)；
严重肝肾功能障碍的患者禁用；
未证明骨转移灶确实存在的患者不推荐使用；
脊椎转移造成脊髓压迫者或瘫痪的患者不推荐使用；
进行过细胞毒素治疗的患者不推荐使用；

【注意事项】
应用本品前，应先证明病人骨转移灶确实存在。
本品为骨转移癌性骨痛的治疗剂。
本品为放射性药物，应严格按照国家药品监督管理部门对放射性药物使用和管理的有关规定操作、防护和使用。
使用本品前应对病人做血液学检查，使用指标：白细胞计数大于3500/mm3 、血小板计数大于80000/mm3 ； 如达不到使用指标可以调理或遵医嘱用药物达到上述指标并稳定1/2—1个月后再使用本品。
使用后有可能会出现造血组织抑制(白细胞及血小板总数会有一定下降)，可逐渐恢复；需定期做血液学复查，周期1/2—1个月/次或遵医嘱治疗。
给药后数天，部分病人可能会出现短期疼痛加剧症状，一般持续时间短于1周，这是正常的一过性反应，可暂时用止痛药减轻或遵医嘱治疗。
病人可接受再次治疗，间隔遵医嘱。
本品为放射性药物，必须在专业医生指导下使用。
即使没有明确的骨髓抑制毒理，在4周内接受过放疗或化疗患者慎用。

【药物相互作用】
尚无明确。

【包装】
1瓶/每铅罐

【药物分类】
其他肿瘤用药及支持疗法

http://114.215.29.196/thread-15458-3-1.html   23楼


锶-89的骨转移疼痛治疗  

支持康来的观点，Sr-89是用来减轻骨痛、提高生活质量的，不是用来治疗骨转移的。

Strontium-89 Chloride
https://medlineplus.gov/druginfo/meds/a601004.html


About your treatment
Your doctor has ordered the drug strontium-89 chloride to help treat your illness. The drug is given by injection into a vein or a catheter that has been placed in a vein.

This medication is used to:
relieve bone pain

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Strontium-89 chloride is in a class of drugs known as radioisotopes. It delivers radiation to cancer sites and ultimately decreases bone pain. The length of treatment depends on the types of drugs you are taking, how well your body responds to them, and the type of cancer you have.

Precautions
Before taking strontium-89 chloride,

• tell your doctor and pharmacist if you are allergic to strontium-89 chloride or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin and vitamins.
• tell your doctor if you have or have ever had bone marrow disease, blood disorders, or kidney disease.
• you should know that strontium-89 chloride may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you should not assume that you cannot get pregnant or that you cannot get someone else pregnant. Women who are pregnant or breast-feeding should tell their doctors before they begin taking this drug. You should not plan to have children while receiving chemotherapy or for a while after treatments. (Talk to your doctor for further details.) Use a reliable method of birth control to prevent pregnancy. Strontium-89 chloride may harm the fetus.
• notify any health care professional (especially other doctors) giving you treatment that you will be taking strontium-89 chloride.
• do not have any vaccinations (e.g., measles or flu shots) without talking to your doctor.
  

Side effects
Side effects from strontium-89 chloride are common and include:

• increased pain starting 2 to 3 days after treatment and lasting 2 to 3 days
• flushing
• diarrhea
  

Tell your doctor if the following symptom is severe or lasts for several hours:

• fatigue
  

If you experience any of the following symptoms, call your doctor immediately:

• unusual bruising or bleeding
• no decrease in pain 7 days after treatment
• fever
• chills
  

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Special instructions
Because this medication may be present in your blood and urine for about 1 week after an injection, you should follow certain precautions during this time. Use a normal toilet instead of a urinal, if possible, and flush the toilet twice after each use. Also wash your hands with soap and water after using the toilet. Wipe any spilled urine or blood with a tissue and flush the tissue away. Immediately wash any stained clothes or bed linens separately from other laundry.

The most common side effect of strontium-89 chloride is a decrease of blood cells. Your doctor may order tests before, during, and after your treatment to see if your blood cells are affected by the drug.

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