肿瘤骨转移疼痛的放射治疗  

Radiation Therapy for Pain in Tumor Bone Metastases

作　　者：季海涛 韩惠娟 吴大威 葛德新 张国辉 于忠凯 许战武 张宏志 Ji Haitao;Han Huijuan;Wu Dawei(Department of Radiotherapy,No.961 Hospital,Joint Logistics Support Force of PLA,Qiqihar,Heilongjiang,161000,China)

机构地区：[1]解放军联勤保障部队第961医院放疗科,黑龙江齐齐哈尔161000 [2]解放军联勤保障部队第962医院肿瘤科,黑龙江哈尔滨150086 [3]解放军联勤保障部队第961医院呼吸科,黑龙江齐齐哈尔161000 [4]解放军联勤保障部队第962医院骨科,黑龙江哈尔滨150086

出　　处：《黑龙江医学》2024年第21期2686-2688,F0003,共4页Heilongjiang Medical Journal

摘　　要：详述了放射治疗在骨转移痛舒缓治疗中的应用策略。骨转移痛常见于肺癌、乳腺癌和前列腺癌等实体瘤,局部外照射对局限性骨转移痛有良好疗效,单次大剂量放疗(如8 Gy)可快速缓解疼痛,但存在再治疗风险。立体定向体部放射治疗(SBRT)在特定条件下,如针对常规放疗效果不佳的肿瘤或骨寡转移患者,可更好地进行局部控制和缓解疼痛,但需关注椎体压缩骨折等并发症。针对复发或弥漫性骨痛,可采用再次放疗、SBRT、局部热消融或放射性药物治疗。骨转移痛支持治疗中强调充分镇痛及使用破骨细胞抑制剂可以降低骨骼相关事件风险,而针对弥漫性骨痛可选用骨靶向放射性同位素或半身照射。放射治疗在骨转移痛管理中具有重要作用,需进行治疗方式个体化选择,SBRT的优势与安全性有待进一步研究证实。The paper explores the application strategy of radiotherapy in the soothing treatment of bone metastasis pain.Bone metastatic pain is common in solid tumors,such as lung cancer,breast cancer and prostate cancer.Local external irradiation has good effect on localized bone metastatic pain.A single large dose of radiotherapy(such as 8 Gy)can quickly relieve pain,but there is a risk of retreatment.Stereotactic body radiotherapy(SBRT)can provide better local control and pain relief under certain conditions,such as patients with tumors or bone oligmetastasis with poor conventional radiotherapy,with complications such as vertebral compression fractures.For recurrent or diffuse bone pain,reradiotherapy,SBRT,local thermal ablation,or radiopharmaceuticals are conducted.In the supportive treatment of bone metastasis pain,adequate analgesia and the use of osteocast inhibitors to reduce the risk of bone-related events.For diffuse bone pain,bone-targeted radioisotope or half body irradiation can be used.Radiation therapy plays an important role in the management of bone metastasis pain,and the treatment method needs to be individualized.The advantages and safety of SBRT need to be confirmed by further studies.

关 键 词：骨转移痛 放射治疗 立体定向体部放射治疗 外照射 

分 类 号：R730.55[医药卫生—肿瘤]