Fukuma H, Beppu Y, Chuma H, Egawa S, Oyamada H, Terui S
Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1729-38.
Eight hundred and thirty-six patients with metastatic cancer in the bone excluding autopsy findings, occurring between January, 1976 and December, 1985 were reviewed. The most frequent site of primary focus was the breast (33.2%), followed by lung (24.6%). Three hundred and forty-two patients (40.9%) were male and 494 (59.1%) female. Diagnosis of bone metastasis was based on abnormal accumulation in the bone scintigram and abnormal findings in the bone X-ray at the same site. Out of 836 patients, 285 had metastatic skeletal lesion including extremities and 43 had a solitary lesion of the extremity. The most frequent site of bone metastases in the extremity was proximal femur and involvement of the femur was 65.2% and that of humerus was 25.6%. The majority of the patients were treated by irradiation (24.9%), irradiation with chemotherapy and/or hormone therapy (21.1%), chemotherapy (18.6%) and chemotherapy with hormone therapy (17.2%), on the other hand, only 25(8.8%) of 285 patients were treated by surgical procedures. Cumulative survival rate after diagnosis of bone metastasis varied with site of primary focus and 5 year survival rate of all cases was 6.1%. Clinical courses after skeletal metastasis were separated into two types, and one type was breast type which was slow and other type was lung type which was rapid. The most important factor for the prognosis of the patients with bone metastasis is thought to be the primary site of origin.
对1976年1月至1985年12月期间出现的836例骨转移性癌症患者（不包括尸检结果）进行了回顾性研究。原发灶最常见的部位是乳房（33.2%），其次是肺（24.6%）。342例患者（40.9%）为男性，494例（59.1%）为女性。骨转移的诊断基于骨闪烁图中骨的异常积聚以及同一部位骨X线的异常表现。在836例患者中，285例有包括四肢在内的转移性骨骼病变，43例有四肢孤立性病变。四肢骨转移最常见的部位是股骨近端，股骨受累率为65.2%，肱骨受累率为25.6%。大多数患者接受了放射治疗（24.9%）、放射治疗联合化疗和/或激素治疗（21.1%）、化疗（18.6%）以及化疗联合激素治疗（17.2%），另一方面，285例患者中只有25例（8.8%）接受了外科手术治疗。骨转移诊断后的累积生存率因原发灶部位而异，所有病例的5年生存率为6.1%。骨骼转移后的临床病程分为两种类型，一种是进展缓慢的乳房型，另一种是进展迅速的肺型。骨转移患者预后的最重要因素被认为是原发起源部位。
