骨骼轉移的單次與分次緩和性放射治療的比較：一個前瞻性隨機試驗

Single Dose Versus Fractionated Palliative Radiotherapy of Bone Metastases: A Prospective Randomized Trial

陳虹汶(Hong-Wen Chen) ； 賴允亮(Yuen-Liang Lian) ； 張國華(Kuo-Hwa Chang) ； 陳裕仁(Yu-Jen Chen) ； 鍾昌宏(Chang-Hung Chung) ； 吳孟浩(Meng-Hao Wu) ； 王銘志(Ming-Chin Wang) ； 邱世哲

《放射治療與腫瘤學》 6卷4期 (1999/12) Pp. 239-245

https://doi.org/10.6316/TRO/199906(4)239

摘要

前言：對解除骨轉移所引起的疼痛，最適切的緩和性放射治療計劃仍未有定論。本研究目的在比較兩種不同的放射治療方式對骨轉移性疼痛的治療效果。
材料與方法：共有36位因骨轉移而引起疼痛的癌症患者進入本前膽性隨機試驗。病人隨機分派成兩組，第一組用6Gy的單次劑量放射治療。第二組病人用30Gy分成10次的分次劑量放射治療。每位病人共追蹤三次，治療開始前一次、治療完成後三天及一個月後各一次。由病人依主觀的感受給分，藉以評估此兩種放射治療方式的治療效果。
結果：此兩種放射治療計劃在疼痛緩解的程度、疼痛緩解後所能持續的時問、日常生活因骨疼痛而受限制的程度、以及（口惡）心嘔吐的狀況上。並無顯著的差異。但在6Gy的單次劑量放射治療後三天，疼痛發作的頻率便有顯著的降低(p=0.001)，並持續到治療後一個月(p=0.003)；且病患覺得疲憊的程度，較分次劑量放射治療輕(p=0.003)。
結論：對存活期不長的癌症末期病人，一次6Gy的單次劑量放射治療，提供了治療骨轉移疼痛一個更安全有效，而又快速的方式。

關鍵字

骨轉移 ； 緩和性放射治療 ； 單次治療 ； 分次治療

並列摘要

Introduction: The most optimal radiotherapy schedule for palliative irradiation of painful bony metastases remains controversial. This study compares the therapeutic efficacy of two radiotherapy schedules in the management of painful bony metastases.
Materials and Methods: Thirty-six patients with painful bony metastases entered the prospective randomized trial. They were randomized to receive either a single 6Gy treatment (Group 1) or a course of 30Gy in ten daily fractions (Group 2). Every patient had three follow-up visits which included at the beginning of treatment, three days, and one month after completion of the treatment. The efficacy of theses two radiotherapy schedules was evaluated by each visit using a self-scoring questionnaire.
Results: There were no significant differences between the two treatment regimens in the degree of pain relief, the duration of pain relief, and the limitation of movement due to metastatic bone pain nor nausea or vomiting. Three days after single 6Gy radiotherapy treatment, the frequency of pain episodes can be reduced significantly (p=0.001) and so do one month later (p=0.003); in addition, these patients had less fatique than patients treated with fractionated radiotherapy (p=0.033).
Conclusion: A single 6Gy radiotherapy offers a safer, easier, and more effective way to manage metastatic bone pain in a terminal patient with a very short life expectancy.

並列關鍵字

Bone metastases ； Palliative radiotherapy ； Fractionation