Schocker J D, Brady L W
Clin Orthop Relat Res. 1982 Sep(169):38-43.
Radiation therapy is an important palliative treatment in the management of patients with metastatic bone disease. Excellent results are obtained following radiation therapy to the involved area when generous margins are employed with appropriate megavoltage devices and time-dose-fractionation/protraction. Often an objective response to treatment occurs, as evident by roentgenograms and by pathologic evaluation. Whether the patient's expected life span is relatively short or relatively long, the approach to treatment of bone metastasis must be done within the context of a multidiscipline management. Close cooperation is necessary among radiation oncologists, medical oncologists, orthopedic surgeons, and physiatrists. Radiation therapy for local persistent symptoms relative to bone metastases is an effective technique for achieving long-term control of localized pain without the need for retreatment. Those patients who have a single metastasis with no other evidences of metastatic disease, and who are best treated aggressively, should be differentiated from those patients who have bone metastases as part of a general pattern of metastatic disease where more conservative radiation therapy techniques would be pursued.
放射治疗是转移性骨病患者管理中的一种重要姑息治疗方法。当使用适当的兆伏级设备以及合适的时间剂量分割/疗程，并采用较大的边界时，对受累区域进行放射治疗可取得良好效果。通常会出现对治疗的客观反应，这在X线片和病理评估中都很明显。无论患者的预期寿命相对较短还是相对较长，骨转移的治疗方法都必须在多学科管理的背景下进行。放射肿瘤学家、医学肿瘤学家、骨科医生和物理治疗师之间密切合作是必要的。针对与骨转移相关的局部持续症状进行放射治疗是一种有效的技术，可在无需再次治疗的情况下实现对局部疼痛的长期控制。那些仅有单一转移灶且无其他转移疾病证据、最适合积极治疗的患者，应与那些骨转移是转移性疾病总体模式一部分且采用更保守放射治疗技术的患者区分开来。
