论文部分内容阅读
目的 :分析脊柱转移瘤的治疗和预后因素。方法 :91例脊柱转移瘤患者于 1992年 1月至 1996年 12月在我院治疗 ,其中放疗 6 6例 ,同位素治疗 2 5例。原发以乳腺癌和肺癌为主 ,各占 2 7.4%和 2 4.1%。治疗前不同程度神经功能障碍的 75例 ,占 82 .4% ,1年以内出现转移的共有 6 4例 ,占 70 .4%。用中位生存期分析生存率差异 ,用L og- rank行差异性检验。结果 :全组中位生存期 10个月 ,乳腺癌最长 ,为 14.5个月 ,其次泌尿系肿瘤为 14个月 ,最短为原发不明者为 2个月。治疗前有不同程度神经功能障碍者中位生存期明显短于仅有局部疼痛者 ,分别为 10个月、3.5个月和 34个月。 1年以内出现继发转移者 ,中位生存期明显较短 ,为 5 .5个月。结论 :放疗、同位素治疗对脊柱转移瘤具有较好的姑息止痛效果 ,总有效率为 78.0 %。影响生存的主要因素有原发部位、治疗前神经功能状况、继发转移出现的早晚和有无脏器转移。
Objective: To analyze the treatment and prognosis of spinal metastases. Methods: Ninety-one patients with spinal metastases were treated in our hospital from January 1992 to December 1996, including 66 cases of radiotherapy and 25 cases of isotope therapy. Primary breast and lung cancer-based, each accounting for 2 7.4% and 2 4.1%. There were 75 cases (82.4%) with neurological dysfunction before treatment and 64 cases (70.4%) with metastasis within 1 year. Survival rates were analyzed by median survival using the Logan rank differential test. Results: The median survival time of the whole group was 10 months, the longest breast cancer was 14.5 months, followed by urinary tumors for 14 months and the shortest was 2 months with unidentified origin. The median survival time of patients with different degrees of neurological dysfunction before treatment was significantly shorter than those with only local pain, which were 10 months, 3.5 months and 34 months respectively. Secondary metastasis within 1 year, the median survival was significantly shorter, was 5.5 months. Conclusion: Radiotherapy and isotope therapy have good palliative analgesic effect on spinal metastases with a total effective rate of 78.0%. The main factors that affect the survival of the primary site, preoperative neurological status, sooner or later secondary metastasis and the presence of visceral metastasis.