乳腺癌骨转移的诊治-ppt课件.ppt

1、乳腺癌骨转移和骨相关疾病的诊断和治疗Diagnosis and treatment of bone metastasis of breast cancer 1ppt课件流行病学Epidemiology 骨转移的比例仅次于肺、肝脏的转移 The ratio of bone metastasis is secondary to lung and liver 通常为多发，单发转移者仅占10% Usually for multiple bone metastasis,only 10% for single 80%为中轴骨，如脊柱和骨盆 80% for axial skeleton, such as t

2、he spine and pelvis2ppt课件目 录Catalogue3ppt课件概 述 l 骨转移是乳腺癌最常见的远处转移部位l Bone metastasis is the most common distant metastases in breast cancer patientsl 晚期乳腺癌骨转移发生率为65%75%l The incidence of bone metastasis in terminal breast cancer is 65%75%l 骨痛、骨相关事件（SREs）及生活质量降低是乳腺癌骨转移的常见并发症l Bone pain, bone related e

3、vents (SREs) and reduced quality of life are common complications of bone metastasis of breast cancer 参考文献 references1.Coleman RE. Cancer Treat Rev. 2001 Jun;27(3):165-76. 2.John R. Johnson, Grant Williams,et al. J Clin Oncol 21:1404-1411. 3.Kinnane N. Eur J Oncol Nurs. 2007;11 Suppl 2:S28-31. Epub

4、2007 Sep 4.4ppt课件诊断方法 Diagnosisl 骨转移初筛诊断方法：骨放射性核素扫描（ECT）l The preliminary screening method of bone metastasis：ECTl 推荐用于出现骨疼痛、骨折、AKP升高、或高钙血症等可疑骨转移的常规初筛诊断检查l It is recommended to be used for patients of bone pain, fracture, AKP elevation, or hypercalcemia l 乳腺癌分期T3N1M0患者常规检查 l Routine examination of p

5、atients with breast cancer stage T3N1M0 l 复发转移乳腺癌患者的常规检查l Routine examination of patients with recurrent metastasis 5ppt课件l 骨转移的影像学确诊检查方法：骨X线/ CT /MRIl Confirmed Radiographic diagnosis of bone metastasis:X-ray/CT/MRIl 60%-78%溶骨性破坏、10%-20%成骨性、12%-20%混合性l Osteolysis 60%-78%, ossify 10%-20%, mixed 12%-

6、20%l 骨活检：诊断乳腺癌骨转移的金标准 l Biopsy: Diagnostic criteria for bone metastasis in breast cancer6ppt课件7ppt课件8ppt课件9ppt课件临床表现l 症状：疼痛、病理性骨折、高钙血症、肢体功能障碍等l Symptoms: pain, pathological fracture, hypercalcemia, and limb dysfunctionl 乳癌骨转移特点：早期一般无症状，晚期疼痛剧烈，以夜间痛为主。l In early stage: general asymptomatic; In the lat

7、e severe pain, and it mainly happens at night10ppt课件治疗方法Treatment l 化疗、内分泌治疗、分子靶向治疗等l Chemotherapy, endocrine therapy, molecular targeted therapyl 镇痛和其他支持治疗 Analgesia and other supportive treatmentsl 双膦酸盐治疗 Diphosphonate l 手术治疗 Operationl 放射治疗 Radiation therapy11ppt课件l 适应症:Indications高钙血症 Hypercalce

8、mia骨痛 Bone pain治疗和预防骨相关事件（SREs） Treatment and prevention of bone related events 明确有骨转移的乳腺癌患者，应首先考虑给予双膦酸盐作为基础治疗 Biphosphonate should be considered as the basic treatment for patients with breast cancer who have been identified with bone metastasis 12ppt课件13ppt课件放射治疗 Radiation therapyl 放疗是乳腺癌骨转移姑息性治疗的

9、有效方法l Radiotherapy is an effective method of palliative treatment for patients with bone metastasis of breast cancerl 放疗的主要作用 The main role of radiotherapy 缓解骨疼痛 Relief of bone pain 减少病理性骨折的危险 Reduce the risk of pathological fracturel 放射治疗方法 Treatment 体外照射（首选方法）External irradiation (preferred method

10、) 放射性核素 Radionuclide14ppt课件15ppt课件手术治疗 Operationl 治疗方法：固定术、置换术和神经松解术l Treatment: fixation, replacement and neurolysisl 治疗选择 Treatment optionsl固定术：选择性用于病理性骨折或脊髓压迫，预期生存时间4周lFixation is used for patients with pathological fracture or spinal cord compression, who are expected to live longer than 4 weeks16ppt课件