平移扫描式全身放疗在恶性肿瘤骨转移中的疗效和安全性研究

目的]探讨平移扫描式全身放疗在恶性肿瘤骨转移中的疗效和安全性。方法]回顾性分析2006年4月至12月接受全身治疗5例多处骨转移恶性肿瘤患者的临床资料。结果]4例患者按预定计划完成放疗,1例患者因Ⅳ度骨髓抑制中断治疗13d。5例患者全身放疗后疼痛完全缓解。1例骨转移病灶完全消失,4例溶骨性病灶部分缩小、钙化。随访至2009年6月,2例存活,3例死亡。治疗期间1例出现Ⅰ度骨髓抑制,4例出现Ⅲ～Ⅳ度骨髓抑制,无视力障碍、放射性肺炎和肝肾、心脏损伤。结论]平移扫描式全身放疗对多处骨转移患者是一项有效的姑息治疗手段,毒性反应可耐受。

A Study on Efficacy and Safety of Translating Scanning Beam-Total Body Irradiation for Patients with Multiple Bone Metastases

Purpose] To investigate the efficacy and safety of translating scanning beam-total body irradiation（TBI） for the patients with multiple bone metastases. Methods] Between Apr. 2006 and Dec. 2006, 5 cases with multiple bone metastases were treated by translating scanning beam-TBI in our hospital, and the medical data were reviewed retrospectively. Results] Schemed treatment was completed in 4 cases and 1 case delayed 13 days with grade Ⅳ myelosuppression. Pain was completely relieved in all cases after TBI. All bone metastatic lesions disappeared in 1 case, bone metastatic lesions partially disminished, recalcified in 4 cases. By Jun. 2009, 3 cases died and 2 cases alive. Grade Ⅲ~Ⅳ myelosuppression occurred in 4 cases and grade Ⅰ myelosuppression in a NPC patient. After TBI, no visual disorder, radiation induced pnumonia, liver dysfunction, renal dysfunction or cardiac dysfunction was found. Conclusion] Translating scanning beam-TBI is an effective palliative treatment method for the patients with multiple bone metastases, and the adverse effect is tolerable.