常规放疗与低分割放疗联合伊班膦酸钠治疗骨转移癌的疗效观察

摘要

Objective To observation the clinical efficacy with conventional fraction and hypo fraction radiotherapy combined with Sodium Ibandronate for bone metastases. Methods 45 patients were divided into two groups, 25 cases received conventional fraction: DY 200 cGy/f, 5 times per week. DT 3 000-5 000 cGy; 20 cases received hypo fraction: DY 400-500 cGy/f, 3 times per week, DT 2 000-4 000 cGy. All of the patients combined with 4-6 cycles of monthly intravenous ibandronate 4 rag. Results Radiotherapy combined with Ibandronate can relieve pain effectively and improve the quality of life. The analgesic effect and improvement of the quality of life was roughly same, without statistical significance (P > 0.05). Conclusion Radiotherapy of bone metastases should be determined by the patients' condition. For the patients with long life span should be treated actively by conventional fraction and high doses. The patients with severe disability and pain should be treated with hypofraction.%目的 观察常规放疗与低分割放疗联合伊班膦酸钠治疗骨转移癌的临床疗效.方法 将45例患者分为两组,常规放疗组25例,采用常规分割照射,200 cGy/次,每周5次,DT 3 000～5 000 cGy;低分割放疗组20例,采用低分割照射,400～500 cGy/次,每周3次,DT 2 000～4 000 cGy.两组患者均每4周应用伊班膦酸钠4 mg加入生理盐水500 mL静滴4h以上,治疗4～6次.结果 放疗合并伊班膦酸钠可有效缓解疼痛,提高生活质量.两组患者止痛效果与生活质量改善大致相同,差异无统计学意义(P＞0.05).结论 骨转移癌的放疗可根据患者的病情轻重、病变部位、预计生存期的长短来选用适当的方法.对于一般情况好、预计生存期长、疼痛较轻的患者,采用常规分割放疗；对于病情相对较重、估计生存期短、疼痛剧烈及行动不便的患者,可采用大剂量短疗程低分割放疗.