三维适形放射治疗腹腔淋巴结转移癌23例临床观察

Three-dimensional Conformal Radiotherapy for Abdominal Lymph Node Metastases:Clinical Observation of 23 Cases

目的分析三维适形放射治疗腹腔淋巴结转移癌的近期疗效和放疗反应。方法2005年5月～2008年11月采用分析三维适形放疗腹腔淋巴结转移癌23例，处方剂量2Gy／次，5次／周，总剂量48～60Gy。近期疗效按WHO实体肿瘤疗效标准评价，正常组织的放射反应按RTOG标准评价。结果治疗结束后3个月，患者完全缓解（CR）6例，部分缓解（PR）13例，总有效率（PR＋CR）为82．6％。近期疗效与病灶体积有关，病灶体积越小效果越好。鳞癌与腺癌的近期疗效相似。结论三维适形放疗腹腔淋巴结转移癌有较好的近期疗效，放疗反应轻。

Objective To evaluate the feasibility of irradiation in abdominal lymph node metastases by using three-dimensional conformal radiotherapy and to assess the irradiation side effects. Methods From May 2005 to Nov.2008,23 patients with abdominal lymph node metastases were treated by three-dimensional conformal radiotherapy. The total irradiation dose was 48-60 Gy,2.0 Gy per fraction over 4.8-6.0 weeks. The immediate response and side effects were evaluated according to the WHO and RTOG criterion system. Results Three months after irradiation, 6 patients achieved complete remission（CR）and 13 patients achieved partial remission（PR）. The total reponse rate（CR＋PR）was 82.6%. The early response was related to the target volume. The smaller the target volume, the better the response. There was no significant difference in the early response between the squamous carcinomas and adenocarcinomas. Conclusion The three-dimensional conformal radiotheraphy is an effective and feasible approach in the treatment of abdominal lymph node metastases.