医护合作策略在脊柱转移瘤容积旋转调强放射治疗中的应用  

Application of medical cooperative strategy in intensity modulated radiation therapy of spinal metastases

作　　者：马慧珍[1] 王宗烨[1] 陈芳[1] 李倩[1] 何慧娟[1] 范佳佳[1] 秦柳花[1] MA Hui-zhen WANG Zong-ye CHEN Fang LI Qian HE Hui-juan FAN Jia-jia QIN Liu-hua(Department of Radiotherapy ,the 306th Hospital of PLA ,Beijing 100101 ,China)

机构地区：[1]中国人民解放军第三0六医院放疗科,北京100101

出　　处：《检验医学与临床》2017年第A01期60-63,共4页Laboratory Medicine and Clinic

摘　　要：目的 探讨医护合作策略在脊柱转移瘤容积旋转调强放射治疗中的应用效果.方法 将24例脊柱转移瘤患者在容积旋转调强放射治疗（VMAT）期间引用医护合作管理,评估患者放疗前后疼痛缓解及脊髓神经功能改善情况,同时监测放射性损伤的情况.结果 24例患者放疗后疼痛部分缓解18例,完全缓解3例,疼痛缓解率为87.5%（21/24）,疼痛缓解伴随强阿片类止痛药使用量下降（P〈0.05）;平均起效时间为放疗后第4.25天.放疗前后疼痛NRS评分分别为（6.21±1.41）和（1.96±1.33）（P〈0.01）.不同程度脊髓神经功能损伤的患者放疗后Frankle分级得到改善.结论 在脊柱转移瘤VMAT治疗期间引入医护合作管理,能有效改善脊柱转移瘤患者疼痛及脊髓神经功能,放射性损伤小,是一种安全、有效的治疗方法,值得在临床应用和推广.Objective To explore the effect of health care cooperation strategy on spinal metastatic tumor volume rotation and intensity modulated radiation therapy.Methods Twenty-four patients with spinal metastases underwent co-management of care during volumetric rotational intensity-modulated radiotherapy（VMAT）.Pain relief and improvement of spinal nerve function were evaluated before and after radiotherapy.Radiation injury was also monitored.Results The overall following-up rate was 100%,the total response rate was 87.5%（21/24）.Among 24 cases,18 cases achieved partial remission and 3 cases achieved complete remission,with a relief rate of 87.5%（21/24）.The average pain relive time was 4.25 days.These improvements were accompanied by significant reduction in opioid use after VMAT（P〈0.05）.Before and after radiation,the pain scores was 6.21±1.41 and 1.96±1.33（P〈0.01）,respectively.After VMAT,the patients who complicated with nerve function impairment recovered to different extent.No one had radiation-induced injury,such as radiation myelitis,radiation pneumonitis,etc.All patients were improved in the quality of life and no evident side-effect was showed.Conclusion It is a safe and effective treatment method to introduce pain management and spinal cord nerve function in patients with spinal metastases after VMAT therapy.It is a safe and effective treatment method and worthy of clinical application and popularization

关 键 词：医护合作 容积旋转调强放射治疗 脊柱转移瘤 疼痛 神经功能 

分 类 号：R730.55[医药卫生—肿瘤]