乳癌骨骼轉移放射線治療的評估

ANALYSIS OF RADIATION THERAPY OF BONY METASTASES OF BREAST CANCER

賴耿光(K. G. Lai) ； 鍾昌宏(Ch. H. Chung) ； 陳光耀(Kuang Y. Chen)

《中華放射線醫學雜誌》 4卷1期 (1979/03) Pp. 50-56

摘要

榮民總醫院癌病治療中心自1962年1月至1978年7月，以放射線治療48例乳癌病人的骨骼轉移病灶。33%的病人於原發性腫瘤治療後1年內發生骨骼轉移，23%在第2年發生，17%在第3年發生。原發性腫瘤分期越早，則平均發生骨骼轉移越遲。約過半數病人有一項或多項實驗室生化檢查不正常，如SGOT、LDH和鹼性矽酸酶增加。大部分骨骼轉移是多發性，最常見的病灶部位是腰椎、骨盆、胸椎和胸廓骨。66.6%的病人於放射線治療後有顯著的效應，16.7%治療效應很差，另16.7治療效果無法評估。效果良好的病人平均生存期較長，生存最長者有4年3個月。因此放射治療可能有延長壽命之效。不過乳癌病人發生骨骼轉移者預後不良，1年和2年生存率只有16和8%。

並列摘要

Between January 1962 and July 1978,48 cases of bony metastases of breast cancer were treated by radiation in the Cancer Therapy Center, Veterans General Hospital. Of these 33% of bony metastases developed in the first year after initial treatment of the primary tumor, 23% developed in the second year and 17% appeared in the third year. Early stage breast cancer patients developed metastases later. More than half the patients had abnormal laboratory tests such as increased of serum glutamic oxalacetic transminase (SGOT), lactic dehydrogenase (LDH) and alkaline phosphatase etc. Majority of bony metastases were multiple and appeared in the lumbar spine, pelvis, dorsal spine and rib cage. On analysis 66.6% of patients showed marked or moderate improvement after radiotherapy, 16.7% being no or poor response, another 16.7% were nonevaluable, Good responders survival longer. However, 1 and 2 years survival rates were only 16 and 8% respectively.