中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (8): 1483-1487.doi: 10.3969/j.issn.1673-8225.2010.08.037

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

骨水泥成形辅以放射治疗应用于恶性肿瘤骨转移癌：可为临床首选方案？

黄引芳，傅  深，吴春根   

  1. 上海市第六人民医院肿瘤放射治疗科，上海市 200233
  • 出版日期:2010-02-19 发布日期:2010-02-19
  • 通讯作者: 傅 深，博士，主任医师，上海市第六人民医院肿瘤放射治疗科，上海市 200233 shen_fu@hotmail.com
  • 作者简介:黄引芳，女，1978年生，上海市人，汉族，2002年上海第二医科大学毕业，医师，主要从事肿瘤放疗方面的研究。 xiaoyinxiaocao@hotmail.com

Bone cementoplasty accompanied by radiotherapy for malignant tumor patients with bone metastaese: To be the first choice?

Huang Yin-fang, Fu Shen, Wu Chun-gen   

  1. Department of Tumor Radiotherapy, Shanghai Sixth Peoples’ Hospital, Shanghai  200233, China
  • Online:2010-02-19 Published:2010-02-19
  • Contact: Fu Shen, Doctor, Chief physician, Department of Tumor Radiotherapy, Shanghai Sixth Peoples’ Hospital, Shanghai 200233, China shen_fu@hotmail.com
  • About author:Huang Yin-fang, Physician, Department of Tumor Radiotherapy, Shanghai Sixth Peoples’ Hospital, Shanghai 200233, China xiaoyinxiaocao@hotmail.com

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摘要：

背景：骨水泥成形具有即刻止痛和稳定骨折的作用，可明显提高肿瘤患者的生活质量，但其用于临床时间尚短，许多学者认为这种技术缺乏远期随访资料和更多病例验证，对复杂部位转移灶的治疗仍值得深入分析。
目的：回顾性分析单纯放射治疗及骨水泥成形辅以放射治疗恶性肿瘤骨转移癌患者的效果。
方法：2006-09/2009-02上海市第六人民医院收治的60例恶性肿瘤骨转移癌患者，随机分成2组，单纯放射治疗组30例，采用6 MV X射线，照射剂量2 Gy/次，5次/周，照射4周，总照射剂量40 Gy；联合组30例，采用骨水泥成形治疗，并辅以放射治疗。采用VRS法疼痛程度分级和目测类比评分法相结合的方式进行骨痛评分，测定起效时间。
结果与结论：治疗前两组患者骨痛评分基本相似(P > 0.05)；治疗后与单纯放射治疗组比较，联合组痛程度显著缓解，骨痛评分明显降低(P < 0.05)。单纯放射治疗组共13例患者治疗无效，联合组共8例患者治疗无效，单纯放射治疗组患者的起效时间迟于联合组。在10个月的随访期内，单纯放射治疗组共有25例患者死亡，联合组共有21例患者死亡，不同随访时间段内联合组生存患者多于单纯放射治疗组。全部死亡病例中均未发现与骨水泥有关的证据，提示应用骨水泥成形辅以放射治疗骨转移瘤比单纯行放射疗法对疼痛的缓解更为有效，可作为骨转移癌首选的治疗方式。

关键词: 放射治疗, 骨转移癌, 经皮穿刺椎体成形术, 疼痛缓解, 骨水泥, 生物材料

Abstract:

BACKGROUND: Bone cementoplasty can elevate the life quality of patients by instant alleviating pain and stable fracture. However, the effects of bone cementoplasty should be further analyzed due to it is lack of long-term follow-up and clinical practices.
OBJECTIVE: To retrospectively analyze the therapeutic effect of bone cementoplasty accompanied by radiotherapy for malignant tumor patients with bone metastaese.
METHODS: Totally 60 malignant tumor patients with bone metastaese treated in Shanghai Sixth Peoples’ Hospital from September 2006 to February 2009 were randomly divided into 2 group, with 30 cases in each group. In the radiotherapy group, patients were exposed to 6 MV X-ray, 2 Gy once, 5 times per week, for 4 successive weeks. In the combination group, patients were underwent bone cementoplasty accompanied by radiotherapy. The combination of verbal rating scale (VRS) and visual analogue scale (VAS) were used to assess bone pain. The onset times of two groups were compared.
RESULTS AND CONCLUSION: The scores of bone pain were similar between before and after treatment (P > 0.05). Compared with the radiotherapy group, the bone pain of combination group was significantly relieved after treatment (P < 0.05). There were 13 patients were ineffective to treatment in the radiotherapy group, which was 8 patients in the combination group. In addition, the onset time of radiotherapy group was later than that of the combination group. In the 10-month follow-up, 25 patients in the radiotherapy group and 21 patients in the combination group were dead. The survival patients of combination group were greater that those of radiotherapy group. No evidence showed that the death was correlated to bone cement, namely, bone cementoplasty accompanied by radiotherapy can be more effective in the treatment of bone metastases than simple radiotherapy, and it might be the first choice in clinical practice.

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