SISSON M A, GARLAND L H
Calif Med. 1951 Oct;75(4):265-70.
The author report clinical experience with 212 cases of mammary cancer metastatic to bone, in 186 of which radiotherapy was given, and in 26 steroid hormone therapy. At least 70 per cent of patients with bone metastasis from breast cancer were relieved of pain by adequate roentgen therapy, the relief lasting for most of the survival time in many instances. About 25 per cent of patients had recalcification or reossification of bony lesions with roentgen therapy; while dramatic, this is not always an indication that relief of pain will continue or that survival time will be lengthened. If and when adequate radiotherapy has not been effective or cannot be administered (for example, in a patient with extremely widespread metastasis, or one residing at a considerable distance from radiotherapeutic service) steroid hormone therapy in adequate dosage is frequently beneficial. From 40 per cent to 75 per cent of patients with bone metastases from breast cancer are relieved of pain by steroid hormone therapy. In about 15 per cent of cases recalcification of the lesion occurs. Effective roentgen therapy may usually be given in a relatively brief period of time (one to two weeks). Effective steroid hormone therapy usually requires from 12 to 24 weeks. Complications of steroid hormone therapy are numerous. Some patients are made considerably worse by such therapy. These complications may only be controlled by reduction or discontinuation of the hormones. For this reason, it is recommended that irradiation always be used as the initial method of palliation.
作者报告了212例乳腺癌骨转移患者的临床经验，其中186例接受了放射治疗，26例接受了类固醇激素治疗。至少70%的乳腺癌骨转移患者通过适当的X线治疗缓解了疼痛，在许多情况下，疼痛缓解持续了大部分生存期。约25%的患者经X线治疗后骨病变出现重新钙化或骨化；虽然这很显著，但这并不总是意味着疼痛会持续缓解或生存期会延长。如果适当的放射治疗无效或无法进行（例如，在转移极为广泛的患者中，或居住在离放疗服务机构较远的患者中），给予足够剂量的类固醇激素治疗通常是有益的。40%至75%的乳腺癌骨转移患者通过类固醇激素治疗缓解了疼痛。约15%的病例病变出现重新钙化。有效的X线治疗通常可在相对较短的时间内（一至两周）进行。有效的类固醇激素治疗通常需要12至24周。类固醇激素治疗的并发症很多。一些患者因这种治疗而病情明显恶化。这些并发症只能通过减少或停用激素来控制。因此，建议始终将放疗作为缓解症状的初始方法。
