Berg Randi S, Yilmaz Mette K, Høyer Morten, Keldsen Nina, Nielsen Ole S, Ewertz Marianne
Department of Oncology, Aalborg Hospital, Aarhus University, Denmark.
Acta Oncol. 2009;48(4):556-61. doi: 10.1080/02841860802488128.
The primary aim of this study was to evaluate the effect of half-body irradiation (HBI) on pain and quality of life in cancer patients with multiple bone metastases. The secondary aim was to evaluate side effects of the treatment.
A total of 44 patients received lower (n = 37), upper (n = 5), or sequential HBI (n = 2). The dose for lower HBI was 8 Gy in one fraction and for upper HBI 7 Gy in one fraction, with reduction of the lung dose to 6 Gy in one fraction by partial shielding. The majority of patients (n = 41) were males with prostate cancers (93%). Outcome and side effects were measured by the EORTC Quality of Life Questionnaire C30 (QLQ-C30), and by the doctors' toxicity scores in the medical record. Pain relief was defined as a reduction of more than 10 points on the QLQ-C30 scale. Evaluations were performed before and 2, 4, 8, 16, and 24 weeks after treatment.
Relief of pain was observed in 76% of the patients receiving HBI with 8.8% of the patients experiencing complete pain relief with no residual pain in the treated field. For most patients, the pain relief was lasting throughout the follow-up period. About one third of the patients were able to reduce their intake of analgesics. Grade 1-2 diarrhoea was the most common side effect observed in 49% of the patients two weeks after treatment. Mild pulmonary symptoms (grade 1-2) were observed in four of seven patients receiving upper HBI. No clear effect was observed on the patients' global quality of life.
Single fraction HBI is safe and effective providing long lasting pain reduction in 76% of patients with multiple bone metastases.
本研究的主要目的是评估半身照射（HBI）对多发性骨转移癌患者疼痛及生活质量的影响。次要目的是评估该治疗的副作用。
共有44例患者接受了下半身照射（n = 37）、上半身照射（n = 5）或序贯HBI（n = 2）。下半身照射剂量为8 Gy单次分割，上半身照射剂量为7 Gy单次分割，通过部分屏蔽将肺部剂量降至6 Gy单次分割。大多数患者（n = 41）为男性前列腺癌患者（93%）。通过欧洲癌症研究与治疗组织生活质量问卷C30（QLQ - C30）以及病历中的医生毒性评分来衡量结果和副作用。疼痛缓解定义为QLQ - C30量表上降低超过10分。在治疗前以及治疗后2、4、8、16和24周进行评估。
接受HBI的患者中有76%观察到疼痛缓解，其中8.8%的患者实现了完全疼痛缓解，治疗区域无残留疼痛。对于大多数患者，疼痛缓解在整个随访期持续。约三分之一的患者能够减少镇痛药的摄入量。1 - 2级腹泻是治疗后两周49%的患者中观察到的最常见副作用。接受上半身照射的7例患者中有4例出现轻度肺部症状（1 - 2级）。未观察到对患者整体生活质量有明显影响。
单次分割HBI安全有效，能使76%的多发性骨转移患者长期缓解疼痛。
