重新治疗骨转移以控制疼痛:2023年ASTRO教育小组
Shing Fung Lee1, Charles B Simone2, Dirk Rades3
1Department of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore.
Annals of palliative medicine
|June 21, 2024
概括
对疼痛骨转移的再照射 (reRT) 显示,单个8 Gy分数对于缓解疼痛的多个分数是不劣的. 这为癌症患者提供了一种不那么有毒,更方便的息性放射治疗选择.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 辐射瘤学 辐射瘤学
背景情况:
- 骨转移是晚期癌症的常见和衰弱的并发症.
- 息性放射治疗 (RT) 对于管理与骨转移相关的疼痛至关重要.
- 当初始RT无法缓解足够的疼痛或疼痛复发时,应考虑重新照射 (reRT).
研究的目的:
- 为了比较单片段 (8 Gy) 与多片段 (20 Gy) 重辐射对疼痛骨转移的疗效和毒性.
- 为了确定疼痛骨转移的患者的reRT最佳剂量分成.
- 评估reRT对疼痛反应,生活质量和功能干扰的影响.
主要方法:
- 一个多中心的,随机的,受控的非劣势性试验 (NCIC CTG SC.20) 涉及850名患者.
- 单个8 Gy分数与多个分数的比较,共计20 Gy.
- 主要终点:2个月整体疼痛反应;次要终点:生活质量,功能干扰和毒性.
主要成果:
- 单分数和多分数臂之间整体疼痛反应没有显著差异,符合非劣等标准.
- 在多分支组中,急性毒性更频繁.
- 响应reRT的患者在功能干扰和生活质量方面经历了显著改善.
结论:
- 单个8 Gy分量是一种可行的,毒性较低,更方便的选择,用于疼痛骨转移的再辐射.
- 支持以患者为中心的息性RT方法,考虑到个体情况.
- 这些发现可能会减少医疗保健负担,并改善患者在息护理机构的舒适性.
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