立体定向适形放疗在胸腔大肿瘤中的应用

Stereotactic conformal radiotherapy for big intrathoracic tumors

目的:报道立体定向适形放疗(stereotacticconformalradiotherapy,SCRT)技术对胸腔大肿瘤患者治疗结果,讨论影响因素。方法:1997年6月～2003年6月,29例胸腔大肿瘤患者接受SCRT。其中非小细胞肺癌19例、浸润性胸腺瘤10例。肿瘤最大直径10～14cm。21例拟常规照射结合SCRT根治放疗,8例拟单纯SCRT姑息放疗。结果:24例患者按计划完成治疗,临床症状明显改善。肿瘤局部总有效率(CR+PR)为82.8%(24/29),根治放疗病例的有效率为100%,姑息放疗病例有效率为37.5%。无2级以上急性及晚期损伤(RTOG/EORTC放射损伤分级)。结论:SCRT是治疗胸腔大肿瘤的有效手段,治疗效果受患者状况、病理类型和放疗剂量等因素影响。

OBJECTIVE：To report the preliminary results of patients with big intrathoracic tumors treated by stereotactic conformal radiotherapy （SCRT） and discuss the effective factors. METHODS： From June 1997 to June 2003, 29 patients with big intrathoracic tumors were treated by SCRT. Of these patients, 19 patients were non-small-cell lung cancer, 10 patients were invasive thymoma. The largest diameter of tumors were ranged from 10 to 14 cm. Twentyone patients aim at radical cure by conventional radiotherapy and SCRT, and 8 patients aim at passive cure only by SCRT. RESLUTS： Twenty-four of 29 patients that underwent treatment according to the plans had a clinical improvement. The effective rates （CR＋ PR） of local tumor controlling were 82.8% （24/29） in all 29 patients, 100% in radical treatment patients, and 37.5% in passive treatment patients. There were no more serious radiation toxicities than degree 2 （by RTOG/EORTC radiation toxicity standards）. CONCLUSION： SCRT was an effective method for big intrathoracic tumor. However, patient＇s state, pathology style, radiotherapy dose and other factors impact the curative effect.