骨转移瘤的综合治疗.pdfVIP

1404 中国肿瘤临床 2010年第37 卷第24 期 骨转移瘤的综合治疗 林建华 陈 飞 王发圣 黄子达 林志成 研究骨转移瘤的发病特点、诊疗方法及进展。 回顾性分析2004 年1 月～2009 年12 月福建医科大学附属 摘要 目的： 方法： 第一医院骨科收治的295 例骨转移瘤患者，治疗前、后对患者进行Karnofsky 生活质量评估及疼痛VAS 评分，并对治疗结果进行研 究。 295 例患者中，男184例，女111例；年龄13~86 岁，平均年龄56.9 岁；原发肿瘤按发生率依次为：肺癌、未明部位恶性肿 结果： 瘤、肝癌、消化道癌、甲状腺癌、乳腺癌、前列腺癌等；骨转移部位依次为：脊柱、骨盆、四肢近端、肋骨、颅骨等。单发性转移52 例， 多发性转移243 例，其中109例患者行手术治疗，其他的治疗方法包括化疗、放疗、激素治疗、二磷酸盐治疗、止痛等综合治疗。治 疗后患者疼痛程度及生活质量均有明显改善，Karnofsky 评分：治疗前50 分，治疗后70 分；疼痛VAS 评分：治疗前5.6 分，治疗后2.7 分，治疗有效率达63.8%。 骨转移瘤作为一种全身性疾病，应采取积极的综合治疗，根据患者情况进行系统评估，制定个体化 结论： 的治疗方案，才能取得较好的疗效。 关键词 骨转移瘤 综合治疗 预后评估 doi:10.3969/j.issn. 1000-8179.2010.24.007 ComprehensiveTreatmentofMetastastaticBoneTumor LIN Jianhua, CHEN Fei, WANG Fasheng, HUANG Zida, LIN Zhicheng Corresponding author: LIN Jianhua, E-mail: jianhual@126.com Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350000, China Abstract Objective:To study the epidemiologic features, methods of diagnosis and treatment, and progress of bone metastasis. Methods: Two hundred and ninety-five cases with a clinical diagnosis of metastatic bone tumor admitted from 2004 to 2009 were reviewed. The Karnofsky scoring system for quality of life and VAS pain assessment score were applied to patients before and after treatment, and the results were analyzed. Results: Among the 295 patients included in the study, 184 were male, and 111 were female. Their ages ranged from 13 to 86 years with an average of 56.9 years. The pri- mary malignant tumors were lung cancer, cancer of unknown origin, liver cancer, gastrointestinal cancer, breast cancer, thy- roid cancer and prostate cancer, in the order of incidence. The most frequently involved bones were spine, pelvis, proxim