循证医学三维适形放疗治疗恶性肿瘤的临床研究

目的 探讨在循证医学指导下 ,三维适形放疗 (3DCRT)治疗恶性肿瘤的临床近期疗效及与其他肿瘤治疗手段配合的最佳方式及存在的相关问题。方法 在循证医学的指导下 ,单用 3DCRT或联合其他治疗手段对 4 3例恶性肿瘤患者进行治疗。方案为 :单用 3DCRT;常规放疗加 3DCRT;3DCRT联合化疗。结果 4 3例总有效率为 35例 (81.3% ) ,CR10例 (2 3.2 % ) ,PR2 5例 (5 8.1% ) ,NR7例 (16 .2 % ) ,PD1例 (2 .3% )。出现急性放射性食管炎 6例 (13.9% ) ,急性放射性肺炎 5例 (11.8% ) ,均为 1～ 2级 ;骨髓抑制较轻 ,均为 1～ 2级 ,共 8例(18.6 % )。治疗后卡氏 (KPS)评分提高者 36例 ,1年生存率为 83.2 % ,中位生存期 16个月。结论 在循证医学的指导下 ,合理安排 3DCRT与其他治疗方式相结合 ,可提高临床近期效果 ,明显改善生存质量且近期毒副作用轻 ,患者耐受性好。

objective To explore the therapeutic short-term effect of 3DCRT in malignant tumor under evidence-based medicine.To find the optimal way of 3DCRT combine with other treatment and explore existent correlation questions.Methods 43 patients were divided into there groups,The first group were treated by 3DCRT only,the second group were treated by 3DCRT plus conventional radiotherapy,the third group were treated by 3DCRT combined with chemotherapy.Results In 43 patients,total response rate was 81.3% with 10(23.2%) CR and 25(58.1%)PR,The disease was stable in 7(16.2%)and progressive in 1(2.3%).The acute`radiation esophagitis rate was 13.9%(n=6),the acute radiation pneumoniasis rate was 11.8%(n=5) with grade 1and2,the supress of bone marrow rate was18.6%(n=8)with grade 1and2,the KPS of 36 patients was improved.1-year survival rate was 83.2%,and the median survival period was sixteen months.Conclusion Under the evidence-based medicine,we could arrange the 3DCRT to conbine with the other therapy methods reasonably,and ascend the clinical short-term effect,and improve the patient survival quality and alleviate adverse reaction.