【摘要】 目的:比较两种不同放疗方案联合热疗治疗骨转移瘤的有效性及安全性。方法:选取骨转移瘤患者85例,随机分为单次放疗组(SF组,43例)和多次放疗组(MF组,42例),两组均采用局部放疗同步联合热疗方式进行止痛治疗。结果:放疗结束1个月后SF组和MF组的疼痛总缓解率分别为79.07%与88.10%(P>0.05);全组患者治疗结束1个月后NRS、KPS评分较治疗前明显下降(均P<0.05),而两组间NRS、KPS评分以及△NRS、△KPS比较均差异无统计学意义(均P>0.05);SF组和MF组在放疗第1～14天内爆发痛发生率分别为32.56%与26.19%(P>0.05);治疗期间两组间1～3级急放射胃肠道损伤、血液学毒性等急性放射性损伤发生率比较均无统计学差异(均P>0.05),全组均未发生4级及以上急性放射损伤;治疗期间两组间的热疗相关不良事件发生率比较均无统计学差异(均P>0.05);治疗结束2年内两组间在疼痛再治疗、骨相关事件发生率等方面比较均无统计学差异(均P>0.05)。结论:在骨转移患者的止痛治疗中,8 Gy/1 f的放疗方案联合热疗在疼痛总缓解率、疼痛评分下降、KPS改善等方面不劣于30 Gy/10 f联合热疗,且没有增加爆发痛、放疗相关不良事件、热疗相关不良事件的发生。更多还原

【Abstract】 Objective:To compare the effectiveness and safety of two different radiotherapy regimens combined with hyperthermia in the treatment of patients with bone metastases.Methods:A total of 85 patients with bone metastases were enrolled.They were randomly divided into the single-fraction radiotherapy group(SF group, 43 cases) and multi-fraction radiotherapy group(MF group, 42 cases).Both groups were treated with simultaneous local radiotherapy combined with hyperthermia for analgesia.Results:One month after the end of radiotherapy, the overall response rates of the SF group and the MF group were 79.07% and 88.10%,respectively(all P>0.05).The NRS,KPS scores and △NRS,△KPS of the two groups were significantly lower than those before the treatment(all P<0.05),while the difference between the two groups in NRS and KPS scores, and △NRS,△KPS between the two groups was not statistically significant(all P>0.05).The incidence of pain flare during the 1-14 days of radiotherapy in the SF group and the MF group was 32.56% and 26.19%,respectively(P>0.05).During the treatment period, there was no significant difference in the incidence of acute radiation injury such as grade 1 to 3 acute radiation gastrointestinal injury and hematological toxicity between the two groups(all P>0.05),and no acute radiation injury of grade 4 and above occurred; there was no statistical difference in the incidence of hyperthermia-related adverse events between the groups(all P>0.05).There was no statistical difference in the re-treatment of pain and skeletal related events between the two groups within 2 years after treatment(all P>0.05).Conclusion:In the analgesic treatment of patients with symptomatic bone metastases, the 8 Gy/1 f radiotherapy schedule combined with hyperthermia is not inferior to 30 Gy/10 f combined with hyperthermia in terms of overall response rate、pain score reduction and KPS improvement.Furthermore, there is no increase in the occurrence of pain flare rate, radiotherapy-related adverse events and hyperthermia-related adverse events.更多还原