鼻咽癌骨转移瘤的综合治疗(附112例临床分析)

Comprehensive treatment of bone metastases of nasopharyngeal carcinoma:a clinical analysis of 112 cases

目的：骨转移是鼻咽癌（Ｎａｓｏｐｈａｒｙｎｇｅａｌｃａｒｃｉｎｏｍａ，ＮＰＣ）ＮＰＣ常见的远处转移部位。其临床症状如骨痛和功能障碍等严重影响患者的生活质量。本文研究改善病人的生存质量的方法。方法：１１２例ＮＰＣ骨转移病人用内照射治疗、放疗、化疗及骨膦药物治疗和综合治疗方法，分单一治疗组和综合治疗组，观察治疗后疼痛缓解和功能障碍的恢复情况。结果：单一方法治疗中，内照射治疗疗效为８２％，高于放疗、化疗和骨膦的效果（Ｐ＜００５），单一治疗总有效率为５５％；综合治疗中，以内照射治疗加放疗的效果最好，达约９０％，高于其它综合治疗组（Ｐ＜００５）；综合治疗组总有效率为７６％，高于单一治疗组（Ｐ＜００５）。对于不同治疗方法，其骨髓毒性和胃肠毒性的比较发现；化疗的毒性高于其它单一治疗方法（Ｐ＜００５）；内照射治疗加化疗的骨髓抑制严重于其它三种综合疗法（Ｐ＜０．０５）。结论：对于ＮＰＣ骨转移患者，尤其是多发性骨转移患者，单一治疗组内照射治疗优于其它三种方法；综合治疗优于单一治疗，综合治疗中内照射治疗加放疗的效果最佳。

Objective:Bone metastasis is common in nasopharyngeal carcinoma(NPC)patients and its main symptom is bone pain or dysfunction,seriously affected patient,life.The aim of dthis paper is to establish methods to try to relieve bone pain and to improve quality of life.Methods: 112 cases of bone metastasis of NPC were divided into 2 groups and treated with either chemotherapy,radiotherapy,innerradiotherapy or bonfas therapy alone or in combination.Result:the effective rate of innerradiotherapy alone is 82% was the most responsive method than the others alone(P<0.05).When the treatment modalities were use comprehensively,the effective rate of innerradiotherapy combined with radiotherapy is 90%,was the most responsive method than the other methods(P<005),total efficiency of the comprehensive treatment was 76% as compared to 55% in patients given single modality treatment(P<0.05).Chemotherapy and chemotherapy with innerradiotherapy showed most serious myelosuppression among 3 methods(P<0.05). Conclusion: Innevradiotherapy alone is the most affective method. comprehensive treatment is recommended.