大分割放疗治疗恶性肿瘤骨转移癌痛的效果

The Effect of Large Fractionated Radiotherapy on Cancer Pain of Malignant Tumor Bone Metastases

目的探讨大分割放疗治疗恶性肿瘤骨转移癌痛的效果。方法选取恶性肿瘤骨转移患者87例,采用随机数字表法将患者随机分为大分割组(n=42)和常规分割组(n=45),其中大分割组给予300 cGy/次,每日1次,每周5次,总剂量3000 cGy;常规分割组给200 cGy/次,每日1次,每周5次,总剂量5000 cGy。观察2组放疗疼痛缓解效果、不良反应等。结果大分割组和常规分割组骨痛缓解总有效率分别为88.89%和92.86%,差异无统计学意义(P>0.05)。常规分割组和大分割组放疗后VAS评分分别为(1.41±0.52)分和(1.50±0.48)分,明显低于放疗前(P<0.05)。大分割组放疗后疼痛缓解开始时间为(5.31±1.21)d,明显短于常规分割组(7.52±1.34)d(P<0.05)。常规分割组和大分割组放疗后卡氏评分分别为(80.15±6.20)分和(81.40±6.72)分,明显高于放疗前(P<0.05)。大分割组消化道不良反应程度高于常规分割组(P<0.05)。结论大分割放疗和常规分割放疗治疗恶性肿瘤骨转移癌痛的效果相当,其中大分割放疗具有止痛起效快的特点,但其引起的消化道不良反应也较多,治疗方案应根据患者具体病情合理选择。

Objective To explore the effect of large fractionated radiotherapy in the treatment of cancer pain of bone metastases of malignant tumor.Methods 87 patients with malignant tumor bone metastasis were selected,the patients were randomly divided into large fractionated group(n=42)and conventional fractionated group(n=45)by random digital table,the large fractionated group was given 300 cGy/times a day,5 times a week,the total dose was 3000cGy,the conventional fractionatedgroup was given 200cGy/times a day,5 times a week,the total dose was 5000cGy;The effect of pain relief and adverse reactions and so on were observed in the 2 groups.Results The curative effect of bone pain relief between the large fractionated group and the conventional fractionated group were 88.89%and 92.86%,there was no significant difference(P>0.05);The VAS scores after radiotherapy in the conventional and large fractionated group were(1.41±0.52)scores and(1.50±0.48)scores,which were significantly lower than those before radiotherapy(P<0.05);The onset time of pain relief in the large fractionated group after radiotherapy was(5.31±1.21)d,which was significantly shorter than that in the conventional fractionated group(7.52±1.34)d(P<0.05);The score of the Karnofsky score of the conventional fractionated group and the large fractionated group was(80.15±6.20)and(81.40±6.72),which were significantly higher than that before radiotherapy(P<0.05);The degree of adverse reactions in the digestive tract of the large fractionated group was higher than that of the conventional fractionated group(P<0.05).Conclusion The effect of large fractionated radiotherapy and conventional fractionated radiotherapy on malignant bone metastases is similar,the large fractionated radiotherapy has the characteristics of rapid onset of pain relief,but it causes more adverse reactions of digestive tract,should choose the treatment plan according to the specific condition of the patients.