CAJ | 학술논문

目的：探讨常规放射治疗配合盐酸羟考酮控释片(奥施康定)对恶性肿瘤骨转移的姑息性止痛治疗效果,减轻疼痛,提高患者的生存质量。方法47例骨转移癌中重度疼痛患者，放疗配合口服药物，共治疗观察5周。第1周,单独口服盐酸羟考酮控释片(奥施康定),起始剂量10mg，每12小时1次,根据疼痛情况调整用量。第2周开始常规放疗（DT 2Gy/次，5次/周,总剂量DT 40Gy/20f）配合口服药物。观察给药后0.5h、1h、12h、24h、72h、每周末（DT 0Gy、DT 10Gy/5f、DT 20 Gy/10f、DT 30Gy/15f、DT 40Gy/20f）以及第3、5周末（放疗剂量至DT20Gy/10f、DT40Gy/20f）暂停应用盐酸羟考酮控释片24h后VAS、KPS评分及不良反应情况，计算中度以上疼痛缓解率。结果第1周内单独应用盐酸羟考酮控释片，中度以上缓解率达95.7%（45/47）；第2周、第3周、第4周末，中度以上疼痛缓解率均在91.5%以上，疼痛控制满意，可部分停药或减少药物应用及相关不良反应；放疗结束（停药）后止痛总有效率91.5%（43/47）；整个配合治疗过程中，患者疼痛控制满意，生存质量改善明显。结论放疗配合盐酸羟考酮控释片治疗对骨转移癌中重度疼痛控制效果好，标本兼治，疗效长短结合,无严重不良反应，是一种安全、有效的止痛治疗组合方法。
목적：탐토상규방사치료배합염산간고동공석편(오시강정)대악성종류골전이적고식성지통치료효과,감경동통,제고환자적생존질량。방법47례골전이암중중도동통환자，방료배합구복약물，공치료관찰5주。제1주,단독구복염산간고동공석편(오시강정),기시제량10mg，매12소시1차,근거동통정황조정용량。제2주개시상규방료（DT 2Gy/차，5차/주,총제량DT 40Gy/20f）배합구복약물。관찰급약후0.5h、1h、12h、24h、72h、매주말（DT 0Gy、DT 10Gy/5f、DT 20 Gy/10f、DT 30Gy/15f、DT 40Gy/20f）이급제3、5주말（방료제량지DT20Gy/10f、DT40Gy/20f）잠정응용염산간고동공석편24h후VAS、KPS평분급불량반응정황，계산중도이상동통완해솔。결과제1주내단독응용염산간고동공석편，중도이상완해솔체95.7%（45/47）；제2주、제3주、제4주말，중도이상동통완해솔균재91.5%이상，동통공제만의，가부분정약혹감소약물응용급상관불량반응；방료결속（정약）후지통총유효솔91.5%（43/47）；정개배합치료과정중，환자동통공제만의，생존질량개선명현。결론방료배합염산간고동공석편치료대골전이암중중도동통공제효과호，표본겸치，료효장단결합,무엄중불량반응，시일충안전、유효적지통치료조합방법。
Objective To evaluate the curing efficacy of radiotherapy combined with controlled-release oxycodone hydrochloride tablets (oxycontin) in malignant tumor with skeletal metastases, relieve pain, improve the quality of life of patients. Methods A total of 47 patients suffering from moderate- severe pain caused by skeletal metastases carcinoma,combined radiotherapy with oral drugs for 5weeks.In the first week, controlled-release oxycodone hydrochloride tablets (oxycontin) alone were taken orally at an initial dose of 10mg q 12h and the dosage was adjusted according to the pain. The second week, conventional radiotherapy(DT 2Gy/f,5f/W) was done and continued to medications(oxycontin) taken continued. VAS, KPS score, and adverse reactions were observed within 1 week(0.5h、1h、12h、24h、72h),and every weekend (DT0Gy, DT 10Gy/5f, 20Gy/10f, DT 30Gy/15f, DT 40Gy/20f). Observed the VAS, KPS score, and the same index was observed at the end of the third and 5th week (DT 20Gy/10f,DT 40Gy/20f) withdrawal controlled-release oxycodone hydrochloride tablets 24hours later. Figured the pain relief rate (moderate or above). Results The first weeks, application of controlled-release oxycodone hydrochloride tablets (oxycontin) alone, remission rate of moderate or above was 95.7% (45/47); the second , third ,and the forth weekend, pain relief rate of moderate or above reached over 91.5%, and pain control was effective, so stop drugs partly or lessen the amount of drugs to reduce the side effects;After Radiation therapy (withdrawal) remission rate of moderate or above was 91.5%(43/47);In the whole treatment process, pain control in patients was satisfactory, the quality of patients’life improved obviously. Conclusion Radiotherapy with controlled-release oxycodone hydrochloride tablets (oxycontin) has good effects to moderate-severe pain caused by control tumor skeletal metastases, treating both symptoms and root causes <br> and has little serious adverse reactions, is a safe and effective analgesic treatment method.