Rieden K, Adolph J, Lellig U, zum Winkel K
Radiologische Universitätsklinik Heidelberg, Abteilung Klinische Radiologie.
Strahlenther Onkol. 1989 May;165(5):380-5.
In a retrospective study on 239 patients irradiated for osseous metastases in 578 different skeletal areas, the therapy effect was evaluated in dependence on the frequency of metastases, the sites of metastases, and the histology of the primary tumors. Furthermore the duration of improved findings was verified. The primary tumor was a mammary carcinoma in 186 patients, a bronchial carcinoma in 21 patients, a renal cell carcinoma in 20 patients, and a prostatic carcinoma in 12 patients. In patients with bronchial carcinoma the relief of pain by radiotherapy was not as good as in other tumor types. However, a significant correlation between subjective therapy effect and histology of the primary tumor was not demonstrated. Remineralization was found in 55% of all irradiated skeletal areas and an unchanged X-ray picture of bone metastases in 35%. A dependence of the objective therapy effect from the histology of the primary tumor was not statistically demonstrated (recalcification rate in mammary carcinoma 62%, in prostatic carcinoma 57%, in bronchial carcinoma 28%, and in renal cell carcinoma 11%). Significant differences of remineralization were found in solitary bone metastases (68%) and in multiple skeletal metastases (56%). A significant correlation between sites of metastases and objective irradiation effect was proved by the fact that osteolytic destructions of spine and pelvis showed a better remineralization than lesions situated in the extremities. The average duration of the objective, radiologically verified amelioration of findings was 16 months in patients with mammary carcinomas and 12 months in patients with prostatic carcinomas, bronchial carcinomas, and renal cell carcinomas.
在一项针对239例接受骨转移瘤放疗患者的回顾性研究中,共对578个不同骨骼部位进行了照射,根据转移瘤的发生频率、转移部位以及原发肿瘤的组织学类型评估了治疗效果。此外,还对病情改善的持续时间进行了验证。原发肿瘤为乳腺癌的患者有186例,支气管癌21例,肾细胞癌20例,前列腺癌12例。在支气管癌患者中,放疗缓解疼痛的效果不如其他肿瘤类型。然而,未发现主观治疗效果与原发肿瘤组织学类型之间存在显著相关性。在所有接受照射的骨骼部位中,55%出现了再矿化,35%的骨转移X线影像未改变。未从统计学上证明客观治疗效果与原发肿瘤组织学类型之间存在相关性(乳腺癌的再钙化率为62%,前列腺癌为57%,支气管癌为28%,肾细胞癌为11%)。在孤立性骨转移(68%)和多发性骨骼转移(56%)中发现了再矿化的显著差异。转移部位与客观照射效果之间存在显著相关性,这一事实表明,脊柱和骨盆的溶骨性破坏比四肢的病变显示出更好的再矿化。乳腺癌患者经放射学证实的客观病情改善的平均持续时间为16个月,前列腺癌、支气管癌和肾细胞癌患者为12个月。