40例椎体骨转移癌的放射治疗观察

Observation on the Radiotherapy of Vertebral Column Metastatic Carcinoma in 40 Cases

目的 探讨常规分割与低分割放射治疗椎体骨转移瘤的效果。方法 40例病人 ,2 1例采用常规分割 ,DT 2 0 0cGy/次 ,每周 5次 ,DT 3 0 0 0～ 5 0 0 0cGy ;19例采用低分割照射 ,DT 3 0 0～ 60 0cGy/次 ,每周 1～ 3次 ,DT 2 0 0 0～ 3 60 0cGy。结果 放疗起到了明显的止痛作用 ,常规分割放疗组与低分割放疗组止痛效果大致相同 ,无统计学意义 (P >0 0 5 )。但放疗对神经系统损害的恢复效果差。结论 椎体放疗应根据病情及预计生存期长短来决定。对一般情况好 ,预计生存期长的病人应采取积极的治疗 ,给予大剂量长疗程的常规分割 ,而对于那些病情相对较重 ,行动又不方便 ,无望长期生存的病人 ,应采取低分割照射 ,且见效快 ,同样起到止痛作用。椎体骨转移应尽早治疗 ,才可能保全或恢复患者的神经功能。

Objective Observation on the efficacy of radiotherapy on vertebral column metastatic carcinoma.Methods 21 patients with metastatic carcinoma of vertebral column were treated with conventional fractionation (CF): received routine radiotherapy 200 cGy per day,5 times a week to a total dose of DT 3 000-5 000 cGy;The hypofractionation radiation (HF) group received the radiotherapy DT 300-600 cGy per day,1-3 times a week to a total dose of DT 2 000-3 600 cGy.Results Radiotherapy was effective in pain relief on vertebral column metastatic carcinoma cases of two groups.But it was less effective in nerve functional resume.Conclusions Both CF and HF radiotherapy could be used in vertebral column metastatic carcinoma.Vertebral column metastatic carcinoma should be treated early.