伽玛刀放疗失败后听神经瘤的显微外科治疗

目的探讨显微外科治疗伽玛刀放疗后进展的听神经瘤病例特点。方法手术切除伽玛刀放疗后进展的听神经瘤患者构成伽玛刀放疗(GKR)组,对照组为未行伽玛刀治疗而行手术治疗患者,对比分析两组患者在临床特点和神经功能保留等方面的差别。结果 GKR组和对照组各纳入14例患者。术中发现GKR组肿瘤与周围神经血管粘连更为紧密。GKR组肿瘤全切率和面神经解剖保留率为92.9%和100%,而对照组均为100%。对照组的远期面神经功能显著优于GKR组。结论全切除伽玛刀放疗后的听神经瘤依然可以获得理想的效果,对于初次治疗的听神经瘤患者,医生应慎重选择伽玛刀治疗,手术仍然是首选方案。     

原发性中枢神经系统淋巴瘤的伽玛刀治疗

目的 :评估伽玛刀治疗原发性中枢神经系统淋巴瘤 (PCNSL)的疗效及探讨对其治疗方案的选择。方法 :3 6例经立体定向穿刺活检或手术病理证实为PCNSL的患者采用伽玛刀治疗 ,并对其临床资料、影像特征、治疗方法和随访结果作一回顾性分析。结果 :3 4例术后 1～ 3周临床症状均明显改善。肿瘤完全缓解 (CR) 3 0例 (83 3 %) ,部分缓解 (PR) 6例 (16 6%) ,卡氏评分迅速由术前的平均 5 0 %上升为平均 80 %,局部控制率为 10 0 %。结论 :伽玛刀是综合治疗本病的安全、有效方法之一 ,立体定向穿刺活检是作为本病的重要诊断方法     

立体定向术联合化疗治疗原发性中枢神经系统淋巴瘤的效果分析

目的探讨立体定向术(MIQ)联合化疗治疗PCNSL的效果分析。方法本次研究随机选取了2013年4月至2015年8月我院收治的50例明确病理后的PCNSL患者,随机分为数目相等的研究组和对照组,所有患者都采用立体定向术进行治疗,研究组加用大剂量甲氨蝶呤+替莫唑胺胶囊以及化疗,最后比较两组患者的治疗效果。结果研究组患者在进行立体定向术后给予化疗,1~3周临床症状明显缓解,近期缓解率为100%,25例患者通过治疗后近期疗效完全缓解22例(88%),部分缓解3例(12%)Karnofsky评分迅速由术前的50%上升为术后的80%,对照组完全缓解20例(80%),部分缓解2例(8%),近期缓解率为88%。研究组局控率以及生存率都明显高于对照组,肿瘤复发情况也较对照组好,数据差异具有统计学意义(P0.05)。结论立体定向术联合化疗治疗PCNSL具有一定的疗效以及安全性,有利于提高患者的生存率和改善预后降低复发率,立体定向术联合化疗也是临床治疗PCNSL的综合治疗方案之一,临床可进一步研究。     

伽玛刀挽救性治疗原发性中枢神经系统淋巴瘤的疗效分析

目的评估伽玛刀挽救性治疗原发性中枢神经系统淋巴瘤(PCNSL)的疗效。方法 23例病理证实为PCNSL的患者,经过以大剂量甲氨蝶呤(MTX)为基础的联合化疗后复发,采用伽玛刀治疗,进行回顾性分析。结果 23例患者,54处肿瘤接受了伽马刀治疗,所有病例接受了以甲氨蝶呤为基础的化疗。伽玛刀治疗情况:平均周边剂量14.4 Gy(11～18 Gy),平均等剂量曲线51.2%(50%～60%)。随访6～54个月,伽玛刀后6个月时评估:完全缓解(complete remission,CR)11例,部分缓解(partial remission,PR)7例,疾病稳定(stable disease,SD)2例,疾病进展(progressive disease,PD)1例。客观缓解率为85.7%。至随访结束时,23例患者中死亡6例,有4例患者肿瘤复发,接受化疗。中位无进展生存期(progression-free survival,PFS)9.5个月。结论伽玛刀挽救性治疗原发性中枢神经系统淋巴瘤痛苦小,安全有效,为大剂量甲氨蝶呤(MTX)为基础的联合化疗后复发患者重要的挽救性治疗方法。     

伽玛刀联合替莫唑胺治疗原发中枢神经系统淋巴瘤的临床观察

目的探讨伽玛刀(gamma knife)联合替莫唑胺(temozolomide,TMZ)放化疗治疗原发中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的疗效及安全性。方法选择2005-06—2016-10山东省安康医院收治的PCNSL患者48例为研究对象,随机分为2组各24例。对照组采用伽玛刀治疗,联合组在对照组治疗基础上应用TMZ联合治疗。比较2组患者治疗后近期疗效、生活质量及不良反应的发生情况及3 a内患者总生存率(response rate,RR)。结果联合组总生存率87.5%,对照组为54.17%,联合组显著高于对照组,差异有统计学意义(χ~2=4.941,P=0.0260.05);联合组Karofsky得分(Karnofsky performance status score,KPS)改善率(62.50%)显著高于对照组(33.33%)(χ~2=4.090,P=0.0430.05);2组恶心呕吐、头痛、白细胞减少、血小板减少和急性脑损伤等不良反应发生率差异均无统计学意义(P0.05);随访3 a,联合组中位生存时间(median overall survival,mOS)24个月,显著长于对照组的15.5个月,差异有统计学意义(P=0.007)。结论伽玛刀联合TMZ可有效改善PCNSL患者的近远期疗效,具有良好的安全性,且可提高患者的生存质量。     

立体定向放射治疗原发性中枢神经系统淋巴瘤的疗效评估

目的 评价立体定向放射治疗(SRT)在原发性中枢系统淋巴瘤(PCNSL)治疗中的作用.方法 回顾分析56例经病理证实的PCNSL,其中26例经常规放疗+化疗治疗,30例经全脑放疗+SRT+化疗治疗.结果 经统计学分析全脑放疗+SRT+化疗组在治疗疗效、治疗的不良反应等方面均好于常规放疗+化疗组.结论 SRT是治疗PCNSL的一种安全、可靠的方法,也是PCNSL联合治疗中有效的手段之一.     

化疗联合三维适形放射治疗脑瘤临床分析

目的分析化疗联合三维适形放射治疗脑瘤的临床疗效及安全性。方法将我院收治的76例脑瘤患者随机分为观察组38例和对照组38例。观察组行化疗联合三维适形放射(3-DCRT)治疗,对照组行单纯化疗。参照WHO制定的实体瘤疗效标准评价2组患者的近期疗效;分别统计患者1~3a内的生存率,并计算无进展生存时间(PFS)和总生存期(OS);同时,评价2组患者的不良反应。结果观察组临床近期疗效的总有效率73.69%,对照组为47.37%,2组比较差异具有统计学意义(P0.05)。观察组1a内生存率、2a内生存率、3a内生存率及平均PFS、OS均高于对照组(P0.05)。在Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级不良反应发生率上,2组比较差异均无统计学意义(P0.05)。结论在常规化疗的基础上联合3-DCRT治疗能有效提高脑瘤的近远期疗效,且安全性好,可作为脑瘤术后一种可行的辅助治疗方案。     

伽玛刀治疗胶质瘤手术后残留(附34例临床分析)

目的 探讨伽玛刀放射神经外科结合短程放疗治疗胶质瘤手术后残留的近期疗效及相关问题.方法 本组34例,其中14例(胶质瘤Ⅰ～Ⅱ级术后残留8例,胶质瘤Ⅱ～Ⅲ级术后残留体积＜3cm3的6例行单纯伽玛刀治疗,周边平均剂量15.4±2.6 Gy,以40%～50%等剂量曲线覆盖残瘤.20例(含Ⅱ～Ⅲ级以上胶质瘤残瘤和胶母细胞瘤术后残瘤)采用伽玛刀结合短程放疗,伽玛刀周边平均剂量20.6±2.4 Gy,以40%～50%等剂量曲线覆盖残瘤,短程放疗总量3200～4000 cGy.结果 平均随访期14.4±6.2个月(6～22个月).单纯伽玛刀治疗组有效率为85.71%;伽玛刀结合短程放疗组有效率为75%;临床症状在治疗15～30天后缓解,放射性反应轻,为一过性,未观察到并发症.结论 良性期胶质瘤术后残留及部分胶质瘤Ⅱ～Ⅲ级术后残留体积小者采用伽玛刀单纯治疗,疗效肯定,短期无复发病例,无毒副反应.恶性胶质瘤术后残留,应用伽玛刀结合短程放疗,近期疗效满意,毒性反应为一过性,复发得以控制或延迟.伽玛刀是胶质瘤重要的辅助治疗方法.     

伽玛刀治疗原发性三叉神经痛疗效分析

目的 评价伽玛刀治疗原发性三叉神经痛的安全性，有效性和心理状态。方法 1997年7月～2002年7月，67例经药物和其他方法治疗无效的原发性三叉神经痛患者接受伽玛刀放射外科治疗，放射剂量中位值是75Gy(70～80Gy)，疗效评价采用患者自我报告疼痛的控制以及药物用量的变化，观察伽玛刀疗效，并通过生活满意度指数A(life satisfaction index A，LSI-A)了解三叉神经痛患者伽玛刀术后主观感受。结果 66例患者(92．4％)完成了随访，平均随访期33个月(8～60个月)，58例患者(87．8％)报告疼痛缓解，疼痛缓解开始出现平均时间为3周(0～24周)。1、2、3年的复发率分别为13％、23％和31％；21例患者出现复发，其中17例接受再次伽玛刀治疗，14例有效；6例(8．9％)患者自觉患侧面部麻胀感，1例(二次治疗者)张口轻度受限。运用LSI-A评定三叉神经痛患者伽玛刀治疗后自我生活满意度改善情况。结论 伽玛刀放射外科治疗三叉神经痛显著缓解疼痛以及提高生存质量，不良反应发生率低，复发后2次伽玛刀治疗有效率高，患者精神心理状态改善。     

伽玛刀联合替莫唑胺治疗脑胶质瘤的临床观察

目的 探讨伽玛刀联合替莫唑胺和伽玛刀治疗恶性脑胶质瘤的效果和安全性.方法 选择2003～2006年经病理证实为恶性胶质瘤的病人,采用病例对照研究的方法,随机分为二组,实验组(35例)在伽玛刀术后采用替莫唑胺5个周期化疗,对照组(48例)仅行伽玛刀治疗.长期随访,观察病人的无进展生存时间和总的生存时间以及药物的安全性.结果 实验组的平均平均生存期为14.2个月,对照组为7.8个月.实验组的2年生存率为20.5%,对照组为10.1%.常见的不良反应为恶心、呕吐等.结论 伽玛刀联合替莫唑胺治疗恶性胶质瘤有效,能提高生存率而毒副反应小.     

The Tumor Control According to Radiation Dose of Gamma Knife Radiosurgery for Small and Medium-Sized Brain Metastases from Non-Small Cell Lung Cancer

ObjectiveThe effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). MethodsWe analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1–3 and 3–5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. ResultsAfter GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0–17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150–0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5–11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. ConclusionThe small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.     

原发性中枢神经系统淋巴瘤影像学特征和疗效分析

目的探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的影像学诊断、治疗及预后,提高临床对PCNSL的认识。方法回顾性分析经术后病理证实的30例免疫正常的原发性中枢神经系统淋巴瘤患者的临床资料。单纯手术8例,手术+化疗14例,手术+化疗+放疗8例。Kaplan-Meier法分析患者生存期。结果PCNSL临床表现主要为颅内压增高和神经功能缺损为主,误诊率高达93.3%。24例PCNSL(占80.0%)MRI明显均匀强化,表现为团块状及结节状强化,或出现具有特异性的"缺口征"、"尖角征"。病理检查均为B细胞淋巴瘤,以弥漫性大B淋巴瘤最多见。Kaplan-Meier分析全组中位生存期32.0个月,2年生存率46.7%。手术+化疗(中位生存期29个月)及手术+化疗+放疗组(34个月)的生存期高于单纯手术组(3个月)。手术+化疗组(64.3%)及手术+化疗+放疗组(62.5%)的2年生存率均高于单纯手术组(0)。放化疗患者肿瘤全切组与次全切组的生存率未见明显的统计学差异(P>0.05)。结论原发性中枢神经系统淋巴瘤影像学缺乏特异性,易误诊;单纯手术治疗不是首选,应尽早采取以放、化疗为主的全身综合治疗。     

HIV-associated primary CNS lymorbidity and utility of brain biopsy

INTRODUCTION: Human immunodeficiency virus (HIV) infection is associated with several central nervous system (CNS) infections and neoplasms. These opportunistic processes generally occur with advanced immunosuppression, but if an accurate diagnosis is made, effective treatment can frequently be initiated. METHODS: In an attempt to assess the safety, diagnostic yield, and utility of stereotactic brain biopsy in the clinical management of suspected HIV-associated primary CNS lymphoma, we retrospectively studied the performance of biopsy in HIV-seropositive patients presenting with focal intracranial lesions. This analysis included 435 patients undergoing brain biopsy, identified through a local case series (n=47) combined with all published cases (n=388). The years of analysis for this study were 1984 and 1997. We also assessed the survival of HIV-associated intracranial mass lesions and of PCNSL patients treated at JHU. RESULTS: Definitive histopathological diagnoses were established in eighty-eight percent of biopsied cases: primary CNS lymphoma (PCNSL) (30%), CNS toxoplasmosis (CNS TOXO) (16%), progressive multifocal leukoencephalopathy (PML) (25%), and other specific diagnoses (17%). Post-biopsy morbidity within thirty days was 8.4% and mortality was 2.9%. PCNSL was the most common diagnosis among cases biopsied after failure of anti-toxoplasmosis therapy, 134/205 (65%). In the local case series, biopsy-related morbidity was associated with poor functional status, decreased platelet count, and number of lesions at presentation. The median survival of irradiated PCNSL cases was 29 days longer than untreated cases (median survival 50 days versus 21 days, respectively, Chi-square=6.73, P<0.01). DISCUSSION: Stereotactic brain biopsy had a high diagnostic yield for HIV-associated focal intracranial lesions, however, the biopsy complication rate in this patient population was relatively high. PCNSL was diagnosed in the majority of patients failing anti-toxoplasmosis therapy. Survival after irradiation for PCNSL remains very poor.     

Chemotherapy is effective as early treatment for primary central nervous system lymphoma

Primary central nervous system lymphoma (PCNSL) is a lymphoma arising within the brain or spinal cord in the absence of evident localisation outside the central nervous system (CNS). Poor results in the management of relapsed PCNSL justify the need for vigorous initial therapeutic regimens, and chemotherapy should not be reserved for recurrent disease. Chemotherapy (M-BACOD scheme) was delivered prior to irradiation in a group of 20 PCNSL patients, another 8 PCNSL patients underwent radiotherapy only, and the overall survival was evaluated. Computed tomography (CT) images in the group of patients treated with chemotherapy, showed there to be 70% complete responders (CR), 15% non-responders (NR) and 15% partial responders (PR). Half of the CR were scheduled for radiotherapy only at tumour recurrence. The median disease-free period and survival time of the whole group treated with early chemotherapy followed by radiotherapy were 24 and 32 months, respectively, but in the subgroup of CR (70%), taking into account also the patients not yet receiving radiotherapy, these were 38 and 48 months, respectively. The disease-free and survival times in the group of CR (75%) of patients treated with radiotherapy only were 13 and 18 months, respectively. At tumour recurrence, CR to chemotherapy had a second disease-free period longer than 2 years after radiotherapy. Our data support the belief that in scheduling the treatment of PCNSL after histological diagnosis, the first step is to devise high-dose chemotherapy with drugs able to cross an intact blood-brain barrier. The results of our primary approach with early chemotherapy in PCNSL support a consensus to continue chemotherapy until tumour recurrence, and only at that event to initiate radiotherapy. It is a challenge and an option worthy of continuing investigation. Received: 12 August 1997 Received in revised form: 14 April 1998 Accepted: 26 April 1998     

Primary CNS lymphoma: combined treatment with chemotherapy and radiotherapy

Primary central nervous system lymphoma (PCNSL), an uncommon tumor, is occurring with increasing frequency. Conventional therapy with corticosteroids and cranial radiotherapy (RT) usually gives a dramatic initial response, but median survival is only 10 to 18 months. Chemotherapy is more successful in comparable systemic lymphoma and has been employed for PCNSL at relapse, causing remission but not cure. Between June 1985 and June 1988, we prospectively staged 32 patients with PCNSL at Memorial Sloan-Kettering Cancer Center and treated 28 on a new protocol that combined chemotherapy and radiotherapy at diagnosis. None had occult systemic lymphoma, but 19% had ocular and 69% had definite or probable leptomeningeal lymphoma. There were no complications in 19 stereotactic biopsies, but 4/10 patients who had a complete resection suffered a severe postoperative deficit. Four patients received RT alone, and 28 received chemotherapy and cranial RT, 17 of whom (group A) received a combination regimen using pre-RT systemic (1 g/m2) and intra-Ommaya methotrexate (MTX), 4,000 cGy whole-brain RT with a 1,440 cGy boost, and 2 courses of post-RT high-dose cytosine arabinoside; 5 other patients received an identical regimen but with a decreased dose of MTX (200 mg/m2). Sixty-three percent of assessable patients had a response to MTX independent of corticosteroid and prior to RT. Eighteen of 26 (69%) assessable patients who received combined therapy are alive with a median follow-up of 25.4 months. Twelve of 16 (75%) assessable group A patients are alive in the same period. Chemotherapy-related toxicity was minimal, and no late toxicities have occurred to date.(ABSTRACT TRUNCATED AT 250 WORDS)     

丁苯酞软胶囊治疗一氧化碳中毒迟发性脑病的临床观察

目的探讨丁苯酞软胶囊治疗一氧化碳中毒迟发性脑病患者的临床疗效。方法将64例一氧化碳中毒迟发性脑病患者随机将其分成对照组和丁苯酞治疗组,每组各32例。对照组给予常规药物联合高压氧治疗,丁苯酞治疗组在常规药物联合高压氧治疗的基础上联合丁苯酞软胶囊治疗。治疗后3个月观察两组患者的简易精神智能量表(MMSE)评分、日常生活活动能力(ADL)量表的Barthel指数(BI)和脑电图(EGG)异常率的变化,并对患者总体疗效进行评价。结果 MMSE评分比较:丁苯酞治疗组患者经治疗后其MMSE评分在26分、20~26分的比例高于对照组(P0.05)。治疗后两组患者的日常生活能力均明显得到改善,且丁苯酞治疗组治疗后BI指数高于对照组(t=7.6617,P0.01),EGG异常率较对照组低(59.3%比87.5%;χ2=4.267,P0.05),总有效率明显高于对照组(96.9%比78.1%,P0.05)。结论在一氧化碳中毒迟发性脑病常规治疗基础上联合丁苯酞软胶囊治疗能够有效改善患者的认知功能及生活质量,减少EGG的异常,提高疗效。     

米氮平联合佐匹克隆治疗老年慢性失眠疗效观察

目的观察分析米氮平联合佐匹克隆治疗老年慢性失眠的临床疗效。方法将80例老年慢性失眠患者随机分为治疗组和对照组各40例,治疗组给予米氮平联合佐匹克隆口服治疗,对照组仅给予佐匹克隆口服,观察2组治疗前和治疗2周、4周8周时匹兹堡睡眠指数(PSQI)评分变化,并以匹兹堡睡眠指数量表减分率为疗效指标进行有效率评定,比较2组治疗前及治疗后不同时间点评分变化有无差异,并对2组治疗后有效率进行比较。结果治疗前2组患者PSQI评分比较无明显差异,治疗2、4、8周后PSQI均较治疗前减低,但治疗2周时2组PSQI评分比较差异无统计学意义P0.05),治疗4周及8周2组PSQI评分进一步减低,且2组评分差异均有统计学意义(P0.05)。治疗8周末,治疗组总有效率95%,对照组总有效率75%,总有效率比较差异有统计学意义(P0.05)。结论佐匹克隆联合米氮平能更好改善老年患者顽固性失眠症,提高治疗有效率。     

Gammaknife radiosurgery in patients with acromegaly

We aimed to evaluate the efficacy and reliability of gamma-knife radiosurgery (GKR) in 22 patients with acromegaly at the Endocrinology-Metabolism Clinic of Cerrahpasa Medical School. We collected data retrospectively from hospital records on disease activity and other pituitary functions, pituitary MRI and visual fields, before GKR and 6, 12, 24, 36, 48 and 60 months after GKR. The median follow-up duration after GKR was 60 months (interquartile range [IQR]: 24-60 months). The remission rate was 54.5% after the 60 months of follow-up. The median growth hormone (GH) level at 60 months after GKR (0.99 ng/mL [IQR: 0.36-2.2]) was significantly lower than the median GH level before GKR (5.65 ng/mL [IQR: 3.85-7.2] (p=0.002). The median insulin-like growth factor-1 (IGF-1) level 60 months after GKR (221.5 ng/mL [IQR: 149-535]) was significantly lower than the median IGF-1 level before GKR (582.5 ng/mL [IQR: 515-655]) (p=0.008). Tumour growth was well controlled in 20 patients (95.2%). Six patients (28.6%) developed new-onset hypopituitarism. We concluded that GKR is an effective adjuvant treatment to control tumour growth, lower GH and IGF-1 levels, and to increase remission rates in patients with acromegaly who were refractory to surgical and medical treatment.     

正念减压疗法联合化疗对骨髓瘤骨病患者生存质量的影响

目的探究正念减压疗法联合化疗对提高骨髓瘤骨病患者的生存质量及疾病缓解率的效果,为改善骨髓瘤骨病患者的生活质量和治疗依从性提供参考。方法选取2018年1月-2020年1月在绵阳市第三人民医院血液科住院治疗的84例骨髓瘤骨病患者为研究对象,采用随机数字表法分为研究组和对照组各42例,两组患者均按BDT(硼替佐米+地塞米松+沙利度胺)化疗方案治疗3~5个周期,研究组在此基础上接受为期8周的正念减压疗法干预。在干预前、干预后第3月、第6月采用卡氏评分表(KPS)评定生存质量,采用疼痛强度数字评分(NRS)评定骨痛程度,按照国际骨髓瘤工作组疗效标准(IMWG标准)进行疗效评估。结果干预后第6个月,研究组和对照组生活质量改善率差异有统计学意义(61.90%vs.33.33%,χ2=6.65,P<0.05)。干预后第3个月及第6个月,研究组NRS评分均低于对照组,差异均有统计学意义(P均<0.05),但两组疾病缓解程度比较差异均无统计学意义(P均>0.05)。结论正念减压疗法联合化疗对改善骨髓瘤骨病患者生存质量、缓解骨痛的效果可能优于单纯传统化疗。