肝癌骨转移瘤应用单次放疗与多次放疗对癌痛、并发症及生活质量的影响

Comparison of cancer pain,complications and life quality in liver cancer patients with bone metastases by different radiotherapy strategy

目的探究肝癌骨转移瘤应用单次放疗与多次放疗对癌痛、并发症及生活质量的影响。方法选取2019年3月至2022年1月南京中医药大学附属南京医院收治的肝癌骨转移瘤患者76例,根据拟定治疗方案将其分为单次放疗组和多次放疗组,均38例,单次放疗组8 Gy/1 f,多次放疗组30 Gy/10 f。放疗后1个月评估疼痛程度、体能、疗效、生活质量、安全性,放疗后随访6个月记录急性脊髓压迫、病理性骨折发生情况。结果单次放疗组和多次放疗组放疗后NSR评分分别为[(2.49±0.57)分、(2.34±0.43)分],KPS评分分别为[(64.53±5.19)分、(66.29±4.86)分],2组放疗后NSR评分均低于放疗前,KPS和QOL评分均高于放疗前(P<0.05)。单次放疗组和多次放疗组疼痛缓解率分别为78.95%、86.11%,胃肠道反应发生率分别为21.05%、27.78%,血液反应发生率分别为13.16%、16.67%,皮肤反应发生率分别为13.16%、11.11%,两组疼痛缓解率和各项并发症发生率比较差异均无统计学意义(P>0.05)。结论对于肝癌骨转移瘤患者实施单次放疗(8 Gy/1 f),在改善患者骨转移病灶的疼痛程度,提升患者的生活质量等方面的效果均不亚于多次放疗(30 Gy/10 f),且患者放疗依从性更高,两种方案毒性反应相近。

Objective To explore the differences on cancer pain,complications and quality of life between the liver cancer patients with bone metastases treated with different radiotherapy strategy.Methods The clinical data of 76 liver cancer patients with bone metastases who were admitted into Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from March 2019 to January 2022 were analyzed retrospectively.According to the therapeutic regimen,the patients were divided into single radiotherapy group(8 Gy/1 F)and multiple radiotherapy group(30 Gy/10 F),with 38 cases in each group.The degree of pain,stamina,clinical efficacy,quality of life and safety were assessed after one month of radiotherapy.The incidence of acute spinal cord compression and pathological fractures were recorded after 6 months of follow-up.Results The NSR scores after radiotherapy in the single radiotherapy group and multiple radiotherapy group were(2.49±0.57)points and(2.34±0.43)points,and the KPS scores were(64.53±5.19)points and(66.29±4.86)points,respectively,which were improved significantly(P<0.05).There was no significant difference on pain relief rates,the incidence rates of gastrointestinal reaction,the blood and skin responses as well(P>0.05).Conclusions Single dose radiotherapy(8 Gy/1f)for patients with bone metastases from liver cancer is no less effective than multiple doses of radiotherapy(30 Gy/10f)in improving the pain degree and the quality of life.Moreover,the patients’radiotherapy compliance is higher with the similarity in toxicity.