放射治疗45例转移性脊髓压迫症的临床观察

Effectiveness of Radiationtherapy in Metastatic Spinal Cord Compression

目的分析恶性肿瘤所致脊髓压迫症的放射治疗疗效。方法选取放疗科2003年4月-2010年8月住院治疗的45例恶性肿瘤所致脊髓压迫症患者,采用放射治疗加激素治疗。直线加速器6MV-X线外照射,照射野范围包括转移椎体上、下各一个正常椎体,位于颈段的病灶用两侧对穿照射,位于胸、腰骶部的病灶照射方式从后背单野或前后野垂直照射。照射剂量300 cGy×10次,5次/周,或200 cGy×20次,5次/周。所有病例放射治疗时辅助使用地塞米松(10mg/d)加20%甘露醇(250 m l/d)静脉滴注。放疗结束后1个月记录患者症状和体征变化,评价疗效。结果背痛总有效率达84.4%(38/45);运动功能改善总有效率为75.6%(34/45);膀胱括约肌功能恢复率37.5%(3/8)。结论恶性肿瘤所致脊髓压迫症患者采用放射治疗加激素治疗症状缓解率高。

Objective To evaluate the effectiveness of radiationtherapy（RT） on metastatic spinal cord compression（MSCC）. Methods Between April 2003 and August 2010,45 patients with MSCC were treated with radiotherapy （300 cGy × 10F or 200 cGy × 20F, five times every weeks）, combined with intravenous drip of dexamethasone （ 10 mg/d） and mannitol. The therapeutic efficacy was evaluated one month after the treatment. Results The response rate for improving the notalgia was 84.4% ;the motor function in 34 cases （75.6%） was improved;the recovery rate of the function of sphincter vesicae. Conclusion Radiotherapy combined with dexamethasone is an effective treatment method for MSCC：