锝[99Tc]亚甲基二膦酸盐注射液单药及联合89SrCl2治疗骨转移瘤效果的meta分析

陈满; 曾飞燕; 李青青; 李宏丹; 林岩松; 冯萍

doi:10.19401/j.cnki.1007-3639.2023.08.004

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锝[⁹⁹Tc]亚甲基二膦酸盐注射液单药及联合⁸⁹SrCl₂治疗骨转移瘤效果的meta分析

论著 | 更新时间：2025-12-31

- 锝[⁹⁹Tc]亚甲基二膦酸盐注射液单药及联合⁸⁹SrCl₂治疗骨转移瘤效果的meta分析
- A meta-analysis of the efficacy of ⁹⁹Tc-MDP alone and in combination with ⁸⁹SrCl₂ in the treatment of bone metastases
- 中国癌症杂志 2023年33卷第8期页码：751-767
- 作者机构：
  
  1. 四川大学华西医院临床试验中心/国家药物临床试验机构/国家药品监督管理局创新药物临床研究与评价重点实验室，四川成都，610041
  2. 中国医学科学院北京协和医院核医学科，北京 100730
- 作者简介：
  
  [ "陈满（ORCID：0000-0001-7030-9968），四川大学华西临床医学院在读硕士研究生。" ]
  冯萍（ORCID：0000-0001-5488-0814），主任医师，四川大学华西医院临床试验中心副主任。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2023.08.004
  中图分类号： R730.53
- 收稿：2023-03-21，
  
  修回：2023-06-30，
  
  纸质出版：2023-08-30
- 稿件说明：
移动端阅览
陈满, 曾飞燕, 李青青, 等. 锝[⁹⁹Tc]亚甲基二膦酸盐注射液单药及联合⁸⁹SrCl₂治疗骨转移瘤效果的meta分析[J]. 中国癌症杂志, 2023,33(8):751-767.

Man CHEN, Feiyan ZENG, Qingqing LI, et al. A meta-analysis of the efficacy of ⁹⁹Tc-MDP alone and in combination with ⁸⁹SrCl₂ in the treatment of bone metastases[J]. China Oncology, 2023, 33(8): 751-767.
陈满, 曾飞燕, 李青青, 等. 锝[⁹⁹Tc]亚甲基二膦酸盐注射液单药及联合⁸⁹SrCl₂治疗骨转移瘤效果的meta分析[J]. 中国癌症杂志, 2023,33(8):751-767. DOI： 10.19401/j.cnki.1007-3639.2023.08.004.

Man CHEN, Feiyan ZENG, Qingqing LI, et al. A meta-analysis of the efficacy of ⁹⁹Tc-MDP alone and in combination with ⁸⁹SrCl₂ in the treatment of bone metastases[J]. China Oncology, 2023, 33(8): 751-767. DOI： 10.19401/j.cnki.1007-3639.2023.08.004.

摘要

背景与目的：

骨转移瘤是常见的肿瘤骨转移疾病，且患者预后较差，常会合并多种严重并发症，包括骨痛、骨折、脊髓压迫等骨相关事件（skeletal-related event，SRE），影响患者的生活质量。放射性核素治疗对骨转移患者具有较好的效果，可以明显地缓解骨痛。本研究旨在评价锝[

]

亚甲基二膦酸盐注射液（

Tc-MDP）单用或联合氯化锶（

SrCl

）治疗骨转移瘤的疗效。

方法：

数据库检索公开发表在2000年1月—2022年7月的关于

Tc-MDP联合

SrCl

及单用

Tc-MDP治疗骨转移瘤疗效的研究报道，对所有纳入的文献进行资料提取和质量评价，采用Revman 5.3软件进行meta分析。

结果：

27篇文献符合纳入标准，共2 564例患者纳入本研究。结果显示，与

SrCl

单药组比较，

Tc-MDP联合

SrCl

可提高骨转移瘤患者的骨痛缓解率（RR=1.22，95% CI：1.18~1.27，

0.001），骨转移灶愈合率（RR=1.35，95% CI：1.25~1.47，

0.001）；单用

Tc-MDP与

SrCl

单药组相比，骨痛缓解率（RR=0.98，95% CI：0.90~1.06，

=0.57）及骨转移灶愈合率（RR=0.93，95% CI：0.82~1.06，

=0.27），差异无统计学意义。

Tc-MDP单用或联合

SrCl

治疗的常见不良反应为白细胞、血小板计数降低，但单用或者联合使用不良反应发生率差异无统计学意义（单用

SrCl

Tc-MDP联合

SrCl

：RR=0.83，95% CI：0.53~1.30，

=0.42；单用

SrCl

单用

Tc-MDP：RR=0.93，95% CI：0.76~1.13，

=0.45）。

结论：

Tc-MDP联合

SrCl

治疗能够有效地缓解骨转移瘤患者的疼痛，其骨转移瘤的骨痛缓解率及骨转移灶愈合率均优于

SrCl

单药治疗组，且不良反应未明显增加。由于本研究在纳入文献质量及数量等方面存在局限性，故今后需要更高质量的随机对照研究验证。

Abstract

Background and purpose:

Bone metastatic tumor is a common disease of tumor bone metastasis

and the prognosis of patients is poor

with a variety of serious complications

including bone pain

fracture

spinal cord compression and other skeletal related events

affecting the quality of life of patients. At present

radionuclide therapy still has positive clinical effects in patients with bone metastasis

and it still plays an important role in relieving bone pain. This study aimed to evaluate the efficacy of technetium [

]

methylene diphosphonate injection (

Tc-MDP) alone or in combination with strontium chloride (

SrCl

) in the treatment of bone metastases.

Methods:

Databases were used to search for studies published between January 2000 and July 2022 on the efficacy of

Tc-MDP in combination with

SrCl

and

Tc-MDP alone in the treatment of bone metastases. All included literature was extracted and evaluated for quality

and Meta-analysis was performed using RevMan 5.3 software.

Results:

Twenty-seven publications met the inclusion criteria

and a total of 2564 patients were included in this study. The results demonstrated that

Tc-MDP combined with

SrCl

improved bone pain relief (RR=1.22

95% CI: 1.18-1.27

0.001) and bone metastasis healing (RR=1.35

95% CI: 1.25-1.47

0.001). However

when compared with

SrCl

alone

it could not be concluded that

Tc-MDP alone increased the rate of bone pain relief (RR=0.98

95% CI: 0.90-1.06

=0.57) and bone metastasis healing (RR=0.93

95% CI: 0.82-1.06

=0.27)

and the difference between the two groups was not statistically significant. The common adverse effects of

Tc-MDP treatment alone or in combination with

SrCl

were decreased leuko

cyte and platelet counts

however

the difference in the incidence of adverse effects between

Tc-MDP treatment alone and in combination with

SrCl

was not statistically significant (

SrCl

Tc-MDP in combination with

SrCl

: RR=0.83

95% CI: 0.53-1.30

=0.42;

SrCl

Tc-MDP: RR=0.93

95% CI: 0.76-1.13

=0.45).

Conclusion:

Tc-MDP combined with

SrCl

treatment was effective in relieving pain in patients with bone metastases

and the bone pain relief rate and bone metastasis healing rate of

Tc-MDP combined with

SrCl

treatment for bone metastases were better compared with the

SrCl

monotherapy group

with no significant increase in adverse reactions after typical dosing. Due to the limitations of the quality and quantity of literature included in this study

higher quality randomized controlled studies are needed.

关键词

Keywords

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