摘要
背景与目的：放射治疗是乳腺癌骨转移姑息性治疗的有效方法,本文通过对乳腺癌骨转移接受放射治疗患者的临床特征、治疗情况的分析,探讨了影响局部控制及生存率的预后因素。方法：回顾性分析了复旦大学附属肿瘤医院放疗科2000年1月—2005年8月收治的186例乳腺癌术后因骨转移而接受放射治疗的患者,其中323处骨转移灶接受了放疗,316处有临床症状。放疗技术采用单一野或前后对穿野的^60Co或6MV X线,照射剂量范围为20-60 Gy,中位剂量30 Gy。结果：乳腺癌骨转移好发部位在胸腰椎、肋骨和髂骨。全组患者中位生存时间为34个月,术后首发为单纯骨转移的112例患者,中位生存时间为37.5个月。放疗后临床缓解（PR＋CR）者占90.8%（287/316处）,完全缓解者占42.1%（133/316处）。临床症状缓解起始时间在4周以内者占75.3%（238/316）,缓解持续中位时间为23个月。生物等效剂量达到39 Gy及以上剂量组患者的中位缓解时间在22个月及以上,而30 Gy及以下者仅为8个月。多因素分析显示激素受体情况、转移淋巴结数目、内脏转移情况、初发单/多发骨转移情况是影响乳腺癌骨转移患者生存率的独立预后因素。结论：放射治疗是乳腺癌骨转移患者姑息治疗的有效方法,大部分患者能达到临床缓解,缓解时间约占中位生存时间的2/3。生物等效剂量达到39 Gy及以上能获得更长的缓解时间。激素受体情况、转移淋巴结数目、内脏转移情况、初发单/多发骨转移情况是影响乳腺癌骨转移患者生存率的独立预后因素。
Background and purpose：Radiotherapy is used commonly to provide pain relief for bone metastases of breast cancer.Our aim was to evaluate the treatment outcome of palliative radiotherapy and the prognostic factors for survival in patients with bone metastasis of breast cancer.Methods：One hundred and eighty-six patients with bone metastases of breast cancer were treated with palliative radiotherapy between Jan.2000 and Aug,2005 were retrospectively analyzed.323 sites received irradiation.Radiation therapy was delivered using ^60 Co or 6 MV X ray. with either a single beam or anterior-posterior beams.The total dose ranged from 20-60 Gy.with a median dose of 30 Gy.Results：Thoracic and lumbar vertebra,ribs and ilium were the most common metastatic sites.The median survival time was 34 months and 37.5 months in the entire cohort and in 112 cases with bone metastasis as first events respectively.Overall clinical response（complete and partial symptom relief）with rediation therapy was achieved in 90.8% of the patients with complete relief in 42.1% of all cases.The onset of symptom relief occurred within 4 weeks after the end of radiotherapy in 75.3% of the patients.The median duration of symptom relief was 23 month,which was over 22 months in those received a BED of ≥39 Gy.and 8 months in the sub-group of ≤30 Gy or less.Hormone receptors status,number of positive nodes,viscera metastasis.and solitary vs multiple skeletal metastases were independent prognostic factors for survival by multivariate analyese.Conclusions：Radiotherapy is an effective palliative approach for patients with bone metastases of breast cancer.Majority of the patients benefited from clinical response and the median duration of symptom relief lasted about 2/3 of the remaining survival time.Receptors status.number of positive nodes,viscera involvement,and solitary vs multiple skeletal metastases were indcpendent prognostic factors for survival.
出处
《中国癌症杂志》
CAS
CSCD
2008年第3期199-203,共5页
China Oncology
关键词
乳腺癌
骨转移
放射治疗
预后因素
breast cancer
bone metastases
radiotherapy
prognstic factors
