Ahmed Shimaa, M Kamal Shereen, Salah Tareq, Fawzy Sedik Mayada, Youssief Ayatallah A
Radiation Oncology, and Nuclear Medicine, Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Anesthesia, Intensive Care Unit and Pain Management Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
J Bone Oncol. 2021 Oct 16;31:100395. doi: 10.1016/j.jbo.2021.100395. eCollection 2021 Dec.
In breast cancer, painful bone metastases are common. Local radiotherapy is the standard treatment of painful bone metastases. Pain control and overall response rateswere low in radiotherapy alone.The objectives of this study were to compare the safety and efficacy of external beam radiotherapy with concurrent capecitabine vs. external beam radiotherapy alone in pain control of painful bone metastases in breast cancer patients.
Eighty-four patients with painful bone metastases from breast cancer participated in this prospective study. We randomized the patients into two groups: group A treated with radiotherapy 30 Gy in 10 fractions and group B treated with capecitabine 825 mg/m every 12 hrs. concurrently with the same radiotherapy dose.
There was no statistically significant difference between the two groups regarding early treatment toxicity. Most of the toxicity was gastrointestinal (diarrhea and nausea) and mild (grade I or II). The median pain score decreased from week one, and there was a marked response at week4. The difference in median pain score between both groups was statistically significant with p-value = 0.045. The median analgesic score in both groups was statistically significant with a p-value = 0.032 at week 12. A complete response to pain at week 4 was 19% and 42.9% in groups A and B, respectively.
Concurrent chemoradiation in painful bone metastases from breast cancer origin was tolerable and safe; it had a higher overall response rate and pain palliation than radiotherapy alone.
在乳腺癌中，疼痛性骨转移很常见。局部放疗是疼痛性骨转移的标准治疗方法。单纯放疗的疼痛控制和总体缓解率较低。本研究的目的是比较外照射放疗联合卡培他滨与单纯外照射放疗在控制乳腺癌患者疼痛性骨转移疼痛方面的安全性和有效性。
84例乳腺癌疼痛性骨转移患者参与了这项前瞻性研究。我们将患者随机分为两组：A组接受10次分割的30 Gy放疗，B组每12小时口服825 mg/m²卡培他滨，同时接受相同的放疗剂量。
两组在早期治疗毒性方面无统计学显著差异。大多数毒性为胃肠道反应（腹泻和恶心）且为轻度（I级或II级）。中位疼痛评分从第1周开始下降，第4周时有明显缓解。两组中位疼痛评分的差异具有统计学显著性，p值 = 0.045。第12周时两组中位镇痛评分具有统计学显著性，p值 = 0.032。第4周时A组和B组的疼痛完全缓解率分别为19%和42.9%。
乳腺癌源性疼痛性骨转移的同步放化疗是可耐受且安全的；与单纯放疗相比，其总体缓解率和疼痛缓解效果更高。
