Schüller H, Wisser L, Pauleit D
Radiologische Klinik der Universität Bonn.
Aktuelle Radiol. 1997 Sep;7(5):274-8.
Bone metastases causing pain syndromes and imminent pathologic fractures are among the main reasons for radiotherapy in patients suffering from malignant tumors. The indication is much influenced by the radiologic findings. Surgical methods are to be chosen in the first place in cases of pathologic fractures or patients with a high risk of such fractures. Different authors recommend various therapeutic regimens. Effective pain control can be achieved with one single dose of radiation. Doses of 6 to 40 Gy applied in one to 19 days are also efficient. Side effects, especially nausea and vomiting occur in 25% of cases; this number rises to 50% in cases of half body irradiation. Visible changes of bone mineral density may be noticed about 6 weeks after termination of radiotherapy. About 70% of osteolytic metastases show progressive sclerosis whereas osteosclerotic lesions may show both increase or decline of bone mass. In spite many years of experience the optimal strategy for radiation therapy of bone metastasis has not been defined; further studies are needed.
骨转移导致疼痛综合征和即将发生的病理性骨折是恶性肿瘤患者接受放射治疗的主要原因之一。放射学检查结果对治疗指征有很大影响。对于病理性骨折或有此类骨折高风险的患者，应首先选择手术方法。不同作者推荐了各种治疗方案。单次放射剂量即可有效控制疼痛。在1至19天内给予6至40 Gy的剂量也有效。副作用，尤其是恶心和呕吐，在25%的病例中出现；半身照射时这一比例升至50%。放疗结束后约6周可能会注意到骨矿物质密度的明显变化。约70%的溶骨性转移显示进行性硬化，而骨硬化性病变可能显示骨量增加或减少。尽管有多年经验，但骨转移放疗的最佳策略尚未确定；仍需要进一步研究。
