Radiotherapy Department, University Hospital Gemelli, Rome, Italy.
Strahlenther Onkol. 2011 Feb;187(2):114-9. doi: 10.1007/s00066-010-2155-9. Epub 2011 Jan 24.
To evaluate the impact of radiotherapy on pain relief and on recalcification in patients with osteolytic lesions due to plasma cell neoplasm.
Pain relief was evaluated according to a 0-10 verbal numerical rating scale (NRS) and recalcification was measured using radiological imaging.
From 1996-2007, 52 patients were treated (Table 1). Median total dose was 38 Gy (range, 16-50 Gy). Pain be-fore radiotherapy was reported by 45 of 52 (86.5%) patients (Table 2) as being severe (8 ≤ NRS ≤ 10) in 5 (11%), moderate (5 ≤ NRS ≤ 7) in 27 (60%), and mild in 13 (29%). Pain relief was achieved in 41 of 45 patients (91%): complete relief was obtained in 21 (51.2%) and partial relief in 20 patients (48.8%); patients with severe pain experienced resolution and none present-ed an increase of pain. Drugs reduction/suspension was achieved in 7 of the 21 patients with complete response. Of 42 patients evaluable for recalcification (Table 3), 21 (50%) presented a radiological response, which was identified as complete in 16 (38%).
Our data confirm the effectiveness of radiotherapy for pain relief, including a reduction in drug intake, and on recalcification, thus, supporting its use in a multidisciplinary approach.
评估放疗法对浆细胞瘤溶骨性病变患者疼痛缓解和再钙化的影响。
疼痛缓解情况根据 0-10 分的口头数字评分量表（NRS）进行评估，再钙化情况则通过放射影像学进行测量。
1996 年至 2007 年，52 例患者接受了治疗（表 1）。中位总剂量为 38 Gy（范围，16-50 Gy）。52 例患者中有 45 例（86.5%）报告了疼痛（表 2），其中 5 例（11%）疼痛严重（NRS≥8），27 例（60%）疼痛中度（5≤NRS≤7），13 例（29%）疼痛轻度。41 例患者（91%）疼痛缓解：21 例（51.2%）完全缓解，20 例（48.8%）部分缓解；疼痛严重的患者疼痛缓解，无患者疼痛加重。21 例完全缓解患者中有 7 例减少或停用药物。42 例可评估再钙化的患者中（表 3），21 例（50%）出现放射影像学反应，其中 16 例（38%）为完全反应。
我们的数据证实了放疗法在缓解疼痛（包括减少药物摄入）和再钙化方面的有效性，支持其在多学科治疗方法中的应用。
