椎体转移瘤患者行外照射治疗期间爆发痛的发生及可能因素分析  

Occurrence and possible factors of burst pain during external beam radiation therapy in patients with vertebral metastases

作　　者：马芹[1] 王苗 刘清磊 MA Qin;WANG Miao;LIU Qinglei(Department of Radiotherapy and Chemotherapy,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei,China;Department of Orthopedics,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院放化疗科,河北沧州061000 [2]河北省沧州中西医结合医院骨科,河北沧州061000

出　　处：《癌症进展》2022年第2期135-138,共4页Oncology Progress

基　　金：河北省中医药类科研计划项目(2020492)。

摘　　要：目的分析椎体转移瘤患者行姑息性外照射治疗期间爆发痛的发生情况及可能因素。方法选取317例恶性肿瘤骨转移患者,均给予外照射治疗,评估放疗爆发痛的发生情况,并分析不同临床特征、放疗疗效与放疗爆发痛的关系。结果317例行椎体外照射治疗的恶性肿瘤骨转移患者中,发生放疗爆发痛145例,未发生放疗爆发痛172例。女性、颈椎/胸椎部位放疗、卡氏功能状态(KPS)评分为71~100分的恶性肿瘤骨转移患者的放疗爆发痛发生率分别高于男性、腰椎或骶椎部位放疗、KPS评分为40~70分的患者,差异均有统计学意义(P﹤0.05)。317例恶性肿瘤骨转移患者中,145例放疗爆发痛患者的爆发痛多出现在放疗开始后的5天内,共103例,占71.03%;32例患者于放疗开始6~10天内出现放疗爆发痛,其余10例于放疗开始10天后出现。共236例锥体外放射治疗患者获得了疗效评价(其余患者失访),完全缓解7例、部分缓解158例、疾病稳定57例、疾病进展14例,疼痛总缓解率为69.92%,语言评价量表(VRS)评分平均降低5.2分。236例获得疗效评价的患者中,发生放疗爆发痛100例,未发生放疗爆发痛136例,分别作为爆发痛组和无爆发痛组,疗效评价结果显示,爆发痛组与无爆发痛组恶性肿瘤骨转移患者的疗效无明显差异(P﹥0.05)。结论女性、高KPS评分、颈椎/胸椎转移患者更容易出现放疗爆发痛。Objective To analyze the occurrence and possible factors of burst pain during palliative external beam therapy in patients with vertebral metastases.Method A total of 317 patients with bone metastases from malignant tumors were selected and treated with external beam radiation therapy.The occurrence of radiotherapy burst pain was evaluated,and the relationship between different clinical features,radiotherapy efficacy and radiotherapy burst pain was analyzed.Result Among the 317 patients with bone metastases from malignant tumors treated with external vertebral irradiation,145 cases of radiotherapy burst pain occurred,and 172 cases did not have radiotherapy burst pain.Women,cervical/thoracic spine radiotherapy,and patients with malignant bone metastases with Karnofsky performance status(KPS)score of 71-100 had higher incidences of radiotherapy burst pain than men,lumbar or sacral spine radiotherapy,and KPS score of 40-70 points,respectively(P<0.05).Among the 317 patients with bone metastases from malignant tumors,145 patients with radiotherapy burst pain mostly occurred within 5 days after the start of radiotherapy,a total of 103 cases,accounting for 71.03%;32 patients developed radiotherapy burst pain within 6 to 10 days after the start of radiotherapy,and the remaining 10 patients developed pain within 10 days after the start of radiotherapy.A total of 236 patients with extrapyramidal radiation therapy were evaluated for efficacy(the remaining patients were lost to follow-up),7 patients had complete remission,158 patients had partial remission,57 patients had stable disease,and 14 patients had progressive disease,the total pain relief rate was 69.92%,and the average verbal rating scale(VRS)score 5.2 points lower.Among the236 patients who were evaluated for efficacy,100 patients had radiotherapy burst pain,and 136 patients did not have radiotherapy burst pain,which were divided into the burst pain group and the no burst pain group.The curative effect evaluation results showed that there was no significant differe

关 键 词：椎体转移 放疗 爆发痛 

分 类 号：R730[医药卫生—肿瘤]