骨转移癌放射止痛治疗的临床效果研究

Analgesic clinical effect of radiotherapy in pain caused by metastatic bone tumors

目的观察两种姑息放射治疗方法对骨转移的晚期肿瘤患者骨转移病灶的临床疗效、副反应。方法 72例患者92处骨转移灶根据患者的预计生存期与病灶部位的不同分为两组,对于估计寿命超过1a的患者给予照射剂量为2GY分割,总剂量为40GY/20 F,共42例44处,均为每周5次;对预计生存期不足1a的患者给予每次剂量为3GY,总剂量30GY/10F,共30例48处。结果常规组有效率86.8%,大分割组有效率91.6%,2组总有效率89.1%,但两组不同分割方式的有效率无统计学差异,P>0.05,两组放疗副反应的发生率相近,且症状较轻。结论放射治疗对骨转移癌疼痛是一种较好的止痛治疗方法,常规放疗、大分割2组放疗方法疗效和副反应相近。

Objective To observe the analgesic effect of radiotherapy in relieving pain caused by bone metastases.Methods Seventy -two patients（92 metastases） undergone irradiation with linear accelerator were divided into two groups of conventional fractionated irradiation （group 1,42 case with 44 metastases≥1-year survival） and larger fractionated dosage（group 2,30 case with 48 metastases1- year survival） by the predicted survival term.Group 1 received the irradiation at a dose of 2 GY/fraction daily（5 days/week） with a dosage range of 40 GY in 4 weeks and Group 2 received the irradiation at a dose of 3 GY/fraction daily（5 days/week） with a dosage range of 30 GY in 2 weeks.Results The analgesic effect of radiotherapy was found in 86.8%of the patients in group 1,and that was 91.6%in group 2. The different fractionated dose gave no difference with regard to pain relief and side effect.Conclusion Radiotherapy is favorable in relieving the pain induced by metastatic bone tumors and the models of fractionated irradiation produce no difference in effet or side effect.