放射治疗诱发恶性肿瘤8例临床分析及文献复习

Radiation induced malignant tumor -a report of 8 cases with literature Review

目的:研究肿瘤放射治疗后诱发恶性肿瘤发生的因素。方法:回顾性分析15年中放射诱发的8例恶性肿瘤,其中原发肿瘤是宫颈癌的5例、上颌窦癌的1例,霍奇金淋巴瘤(HD)1例,子宫内膜癌1例。放射源为6MV-X射线及192Ir源,常规分割照射,照射剂量为46-70Gy。结果:8例放射治疗后3.6-11年在原照射部位出现了肿瘤,其中5例宫颈癌诱发了直肠腺癌3例、膀胱移行细胞癌1例、子宫内膜腺癌1例;1例上颌窦鳞癌诱发了上颌骨骨肉瘤;1例HD诱发了白血病;1例子宫内膜癌诱发右腹股沟横纹肌肉瘤。结论:放射治疗可以诱发恶性肿瘤,主要与照射剂量、照射时年龄、照射部位及照射体积有关。

Objective： To study the etiologic factors of radiation induced malignant tumors. Methods： A retxospecrive study was done on 8 cases of radiation induced malignancies of which the original cancers were uterine cervix 5, maxillary antrum 1 ,Hodgkin＇s disease 1 ,pituitary adenomas 1. The initial radiotherapy was ^192Ir and 6MV X -ray, conventionally fractionated at dose of 46 - 70GY. Results ： After 3.6 - 11 years of the initial radiotherapy, 8 patients developed tumors within the portal, There were rectal cancer, transitional carcinoma of uninany bladder, endometrial carcinoma in 5 cervical carcinomas, osteosarcoma of the maxillary bone in I case of squamous carcinoma of the maxillary antrum . Leukima 1 case of Hodgkin,s disease,soft tissue sarcoma in 1 cases of the pituitary adenomas. Conclusion： The etiologic factors of radiation induced malignancies are total dose,the age in which the initial radiotherapy was given, the volume and the site of radiotherapy.