目的观察射频消融术对肝癌、肺癌及乳腺癌骨转移瘤的临床疗效。方法回顾性分析秦皇岛市第三医院肿瘤科肝癌22例、肺癌12例及乳腺癌8例伴有骨转移瘤患者采用射频消融术治疗情况。观察指标包括射频消融术实施的完整性、可行性及安全性,术前1个月,术后1周及1个月,应用NRS评分评估疼痛的控制,KPS(karnofsky)评分系统评估功能状态,应用EORTC QLQ-C30评估生活质量。结果42例全部成功实施了射频消融术,有11例(26.2%)术后1周内疼痛较术前轻度加重,其余31例疼痛均不同程度缓解。1个月后所有患者疼痛较术前明显缓解(P<0.01)。KPS 评分由术前的(74.05±11.92)分提高到术后的(88.64±6.28)分,功能状态较术前明显好转( P＜0.05)。术前EORTC QLQ-C30评分为(85.50±8.59)分,术后1周为(60.88±9.50)分,术后1个月为(51.38±7.48)分,患者生活质量明显提高(P＜0.05)。结论射频消融术对骨转移瘤的治疗是安全、有效的,并且可明显改善患者癌痛、功能状态和生活质量。

Objective To evaluate the clinical therapeutic effects of bone radiofrequency ablation on patients with bone metastases from hepatocellular carcinoma,lung cancer and breast cancer. Methods To retrospectively analyze 22 hepatocellular carcinoma patients,12 lung cancer patients and 8 breast cancer patients with bone metastases who received radiofrequency ablation at Qinhuangdao No.3 hospital. The mean diameter of the bone metastases was 3.8 cm (range, 1.0-5.5 cm). The integrality,practicability and safety of this procedure were reviewed. The pain relief and of the bone metastases the quality of life were observed before RFA, as well as 1 week after and 1 month after RFA.NRS(numerical rating scale) was used to determine pain level, KPS(Karnofsky) was used to grade functional status. Patients’ quality of life was scored by using EORTC QLQ-C30 system. Results 42 cases (100%) completed RFA successfully. 11(26.2%) cases exhibited worse pain levels within the first week after RFA. However, pains were all relieved significantly after 1 month (P＜0.001). KPS increased dramatically from(74.05±11.92)to(88.64±6.28) before the RFA treatment and after 1 month of it(P＜0.05). EORTC QLQ-C30 scores were also improved significantly, with (85.50±8.59) scores before RFA, and 60.88±9.5 and 51.38±7.48 within 1 week and 1 month ,respectively. Patients’ quality of life increased remarkably (P＜0.05). Conclusions Bone radiofrequency ablation is efficient and safe in the treatment of bone metastases, especially the pain, patients’ life of quality and functional statues that caused by bone metastases were improved dramatically.