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目的探讨关于局部野放射治疗骨转移癌的不同分割方法的止痛效果。方法 109例患者,59例采用常规分割照射(40Gy/20次/28d);50例采用低分割照射(20～30)Gy/(4～6)次/12d。结果放疗起到了明显的止痛作用,常规分割放疗组与低分割放疗组止痛效果大致相似。全部患者止痛显效(CR+PR)为75.2%。常规分割照射组:止痛显效率72.9%(43/59);低分割照射组:止痛显效率为78.0%(39/50)。全部患者生存3个月以上,中位生存时间7个月。1a、2a、3a生存率分别23.9%(26/109)1、8.3%(20/109)、8.3%(9/109)。结论骨转移癌的放射治疗应根据病情来决定。对一般情况好,预计生存期长的患者应积极给予全剂量的常规分割治疗,而对于病情相对较重、行动又不方便、预计生存期短的患者,应采取低分割照射,同样可以起到止痛作用。低分割放疗能够缩短治疗时间,而止痛效果与常规分割相当。
Objective To explore the analgesic effect of different methods of local field radiotherapy on bone metastases. Methods One hundred and ninety-nine patients were treated with conventional fractionated irradiation (40 Gy / 20 times / 28 days) and 50 cases with low-dose irradiation (20-30 Gy / (4-6) times / 12 days). Results Radiotherapy played a significant analgesic effect, conventional radiotherapy group and low-radiotherapy group analgesic effect is similar. Pain relief (CR + PR) was 75.2% in all patients. Conventional split irradiation group: pain relief markedly effective rate was 72.9% (43/59); low split irradiation group: pain relief markedly effective rate was 78.0% (39/50). All patients survived more than 3 months, the median survival time of 7 months. The survival rates of 1a, 2a and 3a were 23.9% (26/109), 1.8.3% (20/109) and 8.3% (9/109) respectively. Conclusion Radiation therapy of bone metastases should be based on the disease. In general, patients with long-term survival expectancy should actively give full dose of conventional fractionation treatment, but for the relatively heavier condition, the action is not convenient, short-lived patients expected to be low-cut irradiation, the same can play Analgesic effect. Low-cut radiotherapy can shorten the treatment time, and analgesic effect and the conventional segmentation.