緩和ケアにおける放射線治療の役割

Radiation therapy is a valuable treatment for palliation of local symptoms with consistently high response rates in the relief and control of bone pain, neurological symptom, obstructive symptoms, and tumor hemorrhage. Over than ８０％ of patients who developed bone metastasis and superior vena cava syndrome obtained symptom relief by radiation therapy. Radiation therapy is also well established as an effective treatment for brain metastasis, improving symptoms and preventing progressive neurological deficits, and recently stereotactic irradiation had became a alternative treatment of surgery for small metastatic brain tumors. Both radiation therapy and surgery are effective in the initial treatment of malignant spinal cord compression syndrome, and no advantages of surgery over radiation therapy has been demonstrated in published series when patients have a previously conformed diagnosis of malignant disease and no evidence of vertebral collapse. The outcome of treatment depends primarily upon the speed of diagnosis and neurological status at initiation of treatment. It is very important to start radiation therapy before patient become non-ambulant. Low irradiation dose and short treatment period of palliative radiation therapy can minimize disruption and acute morbidity for the patients with advanced cancer with enabling control of symptoms and palliative radiation therapy is applicable to the patient even in poor general condition.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html