调强放疗联合内生场热疗治疗恶性肿瘤骨转移性疼痛的临床研究

Clinical study of intensity-modulated radiotherapy combined with local endogenetic thermotherapy for malignant tumor patients with metastatic bone pain

目的:观察调强放疗联合内生场热疗治疗恶性肿瘤骨转移性疼痛的近期疗效。方法:92例恶性肿瘤骨转移患者随机分为实验组(46例)和对照组(46例)。实验组在放疗后1 h内行内生场热疗,对照组行单纯放疗。比较两组患者治疗前后疼痛、生活质量、活动能力变化情况以及爆发痛发生次数、不良反应状况。结果:放疗后两组NRS评分、活动能力分级均较放疗前降低,KPS评分均较放疗前升高(P<0.05),且上述观察指标实验组较对照组放疗前后变化更显著(P<0.05);放疗结束时实验组NRS、KPS及活动能力改善显效率、总有效率均明显优于对照组(P<0.05);实验组放疗过程中爆发痛次数明显少于对照组(P<0.05);两组患者毒副反应比较,差异不具有统计学意义(P>0.05)。结论:调强放疗联合内生场热疗治疗恶性肿瘤骨转移性疼痛近期疗效显著,可明显缓解疼痛,改善生活质量,提高活动能力,降低爆发痛次数,且不增加毒副反应,值得临床推广。

Objective:To observe the recent efficacy of intensity-modulated radiotherapy(IMRT) combined with local endogenetic thermotherapy in the treatment of metastatic bone pain in malignant tumor patients.Methods:A total of 92 malignant tumor patients with metastatic bone pain were randomly divided into the experimental group(46 cases) and the control group(46 cases).The control group were treated by IMRT,the experimental group received local endogenetic thermotherapy within 1 hour after IMRT.The change of pain,life quality and activity ability before and after radiotherapy,number of breakout pain and adverse reaction were compared between two groups.Results:The NRS and activity ability of two groups after radiotherapy were all lower and KPS was higher than those before radiotherapy(P<0.05),and the change in the experimental group were more significant(P<0.05).The marked effective rate and total effective rate of NRS,KPS and activity ability improvement in experimental group were significantly better than those in the control group(P<0.05).The number of breakout pain in the experimental group was significantly less than that in the control group(P<0.05).The adverse reactions had no significant difference in two groups(P>0.05).Conclusion:The clinical efficacy of IMRT combined with local endogenetic thermotherapy in the treatment of metastatic bone pain in malignant tumor patients is significantly,which can obviously relieve pain,improve life quality and activity ability,reduce the number of breakout pain,and do not increase the adverse reactions,so it is worthy of promotion in clinic.