Janicek M J, Hayes D F, Kaplan W D
Department of Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
Radiology. 1994 Jul;192(1):201-4. doi: 10.1148/radiology.192.1.8208938.
To identify the frequency, characteristics, and prognostic significance of scintigraphically detected healing flare in patients with breast cancer metastatic to bone.
Findings on bone scans and concomitant radiographs of 1,188 patients were reviewed. Bone metastases occurred in 426 patients. Outcomes of 101 patients (aged 21-71 years) with skeletal metastases were correlated with typical scintigraphic and radiographic features.
Healing flare with increased radiotracer uptake and radiographically demonstrated sclerotic changes in osteolytic or mixed skeletal metastases were prospectively identified in 12% of patients with skeletal metastases. Healing flare was detected 3.2 months +/- 1.4 after initiation of hormonal treatment or chemotherapy. Skeletal metastatic activity stabilized on bone scans within 6.2 months +/- 3.0. Patients with healing flare did not survive longer than patients without healing flare but with stable metastases after treatment (3.3 years +/- 2.0 vs 3.9 years +/- 1.6).
Scintigraphically detected healing flare represents a favorable response to therapy not associated with increased survival.
确定骨转移乳腺癌患者骨闪烁扫描检测到的愈合耀斑的频率、特征及预后意义。
回顾了1188例患者的骨扫描及同期X线片结果。426例患者发生骨转移。对101例（年龄21 - 71岁）有骨转移的患者的结果与典型的骨闪烁扫描和X线特征进行了相关性分析。
在12%的骨转移患者中前瞻性地发现了愈合耀斑，表现为放射性示踪剂摄取增加，且溶骨性或混合性骨转移在X线片上显示有硬化改变。愈合耀斑在开始激素治疗或化疗后3.2个月±1.4个月被检测到。骨扫描上骨转移活性在6.2个月±3.0个月内稳定。有愈合耀斑的患者生存时间并不比治疗后骨转移稳定但无愈合耀斑的患者长（3.3年±2.0年对3.9年±1.6年）。
骨闪烁扫描检测到的愈合耀斑代表对治疗的一种良好反应，但与生存期延长无关。
