臨床整形外科54巻10号

2019年10月発行

誌上シンポジウム がん診療×整形外科「がんロコモ」

放射線治療医からみたがんロコモ—骨転移に対する放射線治療の問題点

著者： 中村直樹¹

所属機関： ¹国立がん研究センター東病院放射線治療科

ページ範囲：P.1017 - P.1022

　脊髄圧迫や骨折などの骨関連事象を来すと，患者のADLおよびQOLは著しく低下する．がん患者の増加と生存期間の延長に伴い，骨転移患者の骨関連事象に対する診療の重要性が高まっている．

　脊髄圧迫に対し，除圧術と放射線治療のどちらを選択するかは難しい問題であり，多職種で協議して治療方針を決定することが望ましい．放射線治療を行う場合は可及的早期に開始することが望まれる．

　長管骨の溶骨性骨転移で，骨皮質が3cm以上あるいは50％以上破壊されている場合には，予防的固定術(＋術後照射)を行うことが推奨される．放射線治療で骨折リスクが低減できるかどうかに関してはコンセンサスがない．

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