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转移性骨肿瘤放射治疗目的在于止痛,改善患者状态及控制转移瘤发育。放疗可使80%患者解除疼痛。一般预后不良者采取小分割治疗方案,长期生存病例采用多分割治疗方案。但各种治疗方案,对最终止痛效果未见明显差异。作者治疗方案是25Gy/5次/周和30Gy/10次/2周。短期病例的止痛效果1周为42%,2周67%。急性期的副作用是发生在腰椎和骨盆,当照射面积大于100cm~2时出现消化道症状,晚期损伤发生率高。原发灶组织型不同,止痛效果未见明显差异。一般采用高能量X线或~(60)Coγ线对病灶照射,对转移率高的胸腰椎,照射野应包括上下一个椎体,从后方设野。照射野大约7～8 cm。颈椎用侧野,避免照射喉部,咽部。
The purpose of radiotherapy for metastatic bone tumors is to relieve pain, improve patient status and control metastatic tumor development. Radiotherapy can relieve pain in 80% of patients. Patients with poor prognosis generally adopted a small-dividing treatment program, and long-term survival cases used multi-divided treatment programs. However, there was no significant difference in the treatment of the most cessation of pain in various treatment options. The author’s treatment plan was 25 Gy/5 times/week and 30 Gy/10 times/2 weeks. The analgesic effect in short-term cases was 42% in 1 week and 67% in 2 weeks. The side effects in the acute phase occur in the lumbar spine and pelvis. When the irradiation area is greater than 100cm~2, symptoms of the digestive tract appear, and the incidence of late injury is high. Different types of primary lesions did not show significant differences in pain relief. Generally, high-energy X-ray or ~(60)Co? line is used to irradiate the lesion. For the thoracolumbar vertebrae with high metastasis rate, the radiation field should include the upper and lower vertebrae, and the wild should be set from the back. The radiation field is about 7-8 cm. Cervical spine with side field, avoid the throat, throat.