Rief Harald, Heinhold Maximiliane, Bruckner Thomas, Schlampp Ingmar, Förster Robert, Welzel Thomas, Bostel Tilman, Debus Jürgen, Rieken Stefan
Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Radiat Oncol. 2014 Jun 11;9:133. doi: 10.1186/1748-717X-9-133.
To evaluate the local response according to stability after radiotherapy (RT) with a special focus on quality-of-life (QoL), fatigue, pain and emotional distress in patients with unstable spinal bone metastases.
In this prospective trial, 30 patients were treated from September 2011 until March 2013. The stability of osteolytic metastases in the thoracic and lumbar spine was evaluated on the basis of the Taneichi-score after three and six months. EORTC QLQ-BM22, EORTC QLQ-FA13, and QSC-R10 were assessed at baseline, and three months after RT.
After 3 months, 25% (n = 6) and after 6 months 33.3% (n = 8) were classified as stable. QoL, fatigue, and emotional distress showed no difference over the course. The pain response 3 months after RT showed a significant difference (p < 0.001). Pathological fractures occurred in 8.3% of the patients (n = 2) within six months following RT.
Our trial demonstrated that RT can improve stability in one third of patients over a 6-months period with unstable spinal metastases. Importantly, for these patients pain relief was detected but RT had no impact on QoL, fatigue, and emotional distress.
Clinical trial identifier NCT01409720.
评估不稳定脊柱骨转移患者放疗（RT）后根据稳定性的局部反应，特别关注生活质量（QoL）、疲劳、疼痛和情绪困扰。
在这项前瞻性试验中，从2011年9月至2013年3月对30例患者进行了治疗。根据Taneichi评分在3个月和6个月后评估胸腰椎溶骨性转移的稳定性。在基线时以及放疗后3个月评估欧洲癌症研究与治疗组织QLQ-BM22、欧洲癌症研究与治疗组织QLQ-FA13和QSC-R10。
3个月后，25%（n = 6），6个月后33.3%（n = 8）被分类为稳定。在整个过程中，生活质量、疲劳和情绪困扰没有差异。放疗后3个月的疼痛反应显示出显著差异（p < 0.001）。8.3%的患者（n = 2）在放疗后6个月内发生了病理性骨折。
我们的试验表明，放疗可在6个月内使三分之一的不稳定脊柱转移患者的稳定性得到改善。重要的是，这些患者的疼痛得到缓解，但放疗对生活质量、疲劳和情绪困扰没有影响。
临床试验标识符NCT01409720。
