Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Physics, School of Medicine, Iran University of Medical Science, Tehran, Iran.
J Therm Biol. 2019 Aug;84:129-135. doi: 10.1016/j.jtherbio.2019.06.003. Epub 2019 Jun 27.
Since the survival time of patients with bony metastases has noticeably improved in recent years, these patients are at high risk of complications associated with this metastasis. Hence, the appropriate choice of treatment modality or combination of therapeutic approaches can lead to increasing bone pain relief, improving quality of life, etc. This study is aimed to evaluate the effectiveness of combined radiotherapy and hyperthermia for the treatment response of patients with painful bony metastases.
In a single-arm clinical trial, 23 eligible patients (14 female and 9 male) with the mean age of 67 years old and suffering from bony metastases were enrolled in the study. Two hours after radiotherapy, the patients underwent hyperthermia for 1 h in the supine position. All the patients completed the brief pain inventory (BPI) assessment tool and quality of life questionnaire (QLQ-C30) from the European Organization for Research and Treatment of Cancer (EORTC) at the baseline, end of the treatment and 1, 2 and 3 months thereafter. The response to the treatment was assessed as the zero score (complete response) or two or more than two-point drop of the worst pain within the preceding 24 h (partial response) during the 3-month posttreatment.
All the pain intensity and interference scores, except the pain interference with the enjoyment of life score, significantly decreased. A total of 18 out of 23 patients (78%) achieved complete or partial response. The number of patients using pain relief medications decreased from 74% (n=17) at the baseline to 48% (n=11) 3 months later. Moreover, except for nausea and vomiting, appetite loss, diarrhea and financial impact problems, the patients' quality of life improved significantly in all the functional scales and symptoms within 3 months.
This study showed that using hyperthermia in combination with radiotherapy significantly ameliorated bone pain among the patients suffering from cancer with painful bony metastases.
近年来，患有骨转移的患者的生存时间明显延长，这些患者发生与转移相关并发症的风险较高。因此，选择适当的治疗方式或联合治疗方案可以提高骨痛缓解率，改善生活质量等。本研究旨在评估放疗联合热疗对缓解骨转移疼痛患者治疗效果的影响。
在一项单臂临床试验中，共纳入 23 名符合条件的骨转移患者（14 名女性，9 名男性），平均年龄 67 岁。放疗后 2 小时，患者取仰卧位进行 1 小时的热疗。所有患者在基线、治疗结束时以及治疗后 1、2、3 个月时均使用简明疼痛量表（BPI）和欧洲癌症研究与治疗组织（EORTC）生活质量问卷（QLQ-C30）进行评估。治疗 3 个月后，采用 0 分（完全缓解）或 2 分或 2 分以上的最差疼痛缓解（部分缓解）评估治疗反应。
除生活乐趣受疼痛干扰评分外，所有疼痛强度和干扰评分均显著降低。23 例患者中，18 例（78%）达到完全或部分缓解。基线时使用止痛药物的患者比例为 74%（n=17），3 个月后降至 48%（n=11）。此外，除恶心呕吐、食欲下降、腹泻和经济影响问题外，所有功能量表和症状的生活质量在 3 个月内均显著改善。
本研究表明，放疗联合热疗可显著改善癌症骨转移疼痛患者的骨痛。
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