不同剂量分割放疗对恶性胸腺瘤合并重症肌无力的近期疗效比较

Treatment Outcome of Radiotherapy on Myasthenia Gravis in Patients with Malignant Thymoma

要目的要观察和比较不同剂量分割方式下放射治疗对合并重症肌无力的恶性胸腺瘤的近期疗效。方法要53例已行手术切除的合并重症肌无力的恶性胸腺瘤分为常规剂量组(26例,采用常规剂量分割放射)和剂量渐增治疗组(27例,采用剂量渐增方式照射);同时应用抗胆碱酯酶药物控制肌无力症状。观察2组疗效。结果要I、II型患者中常规剂量组疗效好于剂量渐增组(P<0.05)I;II、IV型患者中2组疗效无明显差异(P>0.05)。结论要对恶性胸腺瘤中I、II型肌无力者给予常规分割剂量放疗,较采用剂量渐增方式照射可取得更好的近期疗效。对于III、IV型肌无力或有严重球麻痹症状者,以小剂量开始为宜。

Objective To evaluate the treatment outcome ofmyastheniagravis （MG） during radiotherapy with different fractionation dose for patients with malignant thymomas. Methods 53 patients with malignant thymomas were analyzed. The patients were divided into 2 groups （Group A with DT 1.8-2.0Gy/fraction; Group B started with lower fractionation dose）. Spyridostigmine, an anticholinesterase, was used to control the MG symptoms. Results Myasthenic symptom of these patients was relieved in various degrees. Among type Ⅰ and Ⅱ MG patients, the treatment outcome of Group A was better than that of Group B. Among type Ⅲ and Ⅳ MG patients, there was no significant difference in treatment outcome between Group A and Group B. Conclusion The fractionation of DT1.8-2.0Gy modal would not aggravate MG symptom, but improve the treatment outcome of type Ⅰ and Ⅱ MG patients.