立体定向适形放射治疗腹腔转移性腺癌31例临床分析

Analysis of 31 Patients with Abdominal Metastatic Adenocarcinoma Radiotherapy Using Stereotactic Conformal Radiotherapy

目的研究立体定向放射治疗对腹腔转移性腺癌治疗的临床意义。方法对31例腹腔转移性腺癌病例作立体定向适形放疗。设同中心非共面照射野4￣7个,靶区剂量20￣35Gy,7￣9天。其中11例加常规放疗30￣40Gy,20￣25天。结果临床症状缓解率96.6%,肿块有不同程度的缩小,总有效率为77.4%(24/31)。治疗前肿块体积小于125cm3者明显优于大于125cm3者(P<0.025)。中位生存月数为11个月,一年生存率达25.8%(8/31)。加常规照射者疗效无明显提高(P>0.1),放射性损伤却明显增加,总体损伤率为19.4%(6/31)。结论大多数患者可以耐受立体定向适形放射治疗,通过治疗可改善生存质量,适当延长生存期,但加用常规照射并不能提高疗效,反而增加放射性损伤。

Objective To study the possibility of using stereotactic conformal radiotherapy on abdominal metastatic adenocarcinoma.Methods 31 patients with abdominal adenocarcinoma received stereotactic confomal radiotherapy.Irradiation fielded had 4~7.The dose was 20~35Gy,7~9d, 11 of these patients combined normal radiation at the same time, and the dose was 30~40Gy,20~25d.Results 96.6% patients of clincal symptoms were relieved after treatment.The tumor became smaller in different level and the total effect was77.4%(24/31).The effect to patients with a tumor smaller than 125cm3 is significantly better than those with a tumor bigger than 125cm3.The median survival time was 11 months.1 year survival rate was 25.8%(8/31).The overall damage rate was 19.4%(6/31).Conclusion Stereotatic conformal radiotherapy may be effective in improving the life quality and in prolonging the life expectance.But combining normal radiotherapy at the same time the radiational damage will increase significantly, instead of improvemend effect.