Sonoo H, Shimozuma K, Kurebayashi J, Ohta K, Kiyono T
Dept. of Surgery, Kawasaki Medical School.
Gan To Kagaku Ryoho. 1995 Apr;22 Suppl 1:10-5.
Systemic therapy, pain relief and the quality of life (QOL) of breast cancer patients with bone metastasis were described. QOL was measured using a "QOL questionnaire" developed by the Ministry of Welfare in Japan. It was proved objectively that QOL scores in the cases with bone metastasis were significantly low in terms of activity, physical psychological conditions. Chemoendocrine therapy, endocrine therapy and outpatient therapy showed a high QOL score. The cases with bone pain showed a low QOL scores. In the 45 cases whose first metastatic site was bone only, there were no differences between endocrine therapy and chemoendocrine therapy in the rate and period of response or the total QOL score. MPA showed a higher response rate and a higher pain relief rate than TAM. In the cases with bone metastasis but without severe visceral metastasis, MPA monotherapy showed an excellent response when the tumor was ER or PgR positive, or when there was a long disease-free interval of more than three years, or if there was no previous therapy. MPA monotherapy is a suitable firstline therapy in such cases. Radiation therapy was more effective for bone pain (response rate 96.3%), and it was also effective in cases in which systemic therapy was not.
描述了系统性治疗、疼痛缓解以及骨转移乳腺癌患者的生活质量(QOL)。使用日本厚生省制定的“生活质量调查问卷”来测量生活质量。客观证明,骨转移患者在活动、身体心理状况方面的生活质量得分显著较低。化学内分泌治疗、内分泌治疗和门诊治疗显示出较高的生活质量得分。骨痛患者的生活质量得分较低。在45例仅骨为首个转移部位的病例中,内分泌治疗和化学内分泌治疗在缓解率、缓解期或总生活质量得分方面无差异。甲羟孕酮(MPA)的缓解率和疼痛缓解率高于他莫昔芬(TAM)。在有骨转移但无严重内脏转移的病例中,当肿瘤雌激素受体(ER)或孕激素受体(PgR)阳性,或无病生存期超过三年,或既往未接受过治疗时,MPA单药治疗显示出良好的反应。MPA单药治疗在此类病例中是合适的一线治疗方法。放射治疗对骨痛更有效(缓解率96.3%),在系统性治疗无效的病例中也有效。