调强适形放疗联合热化疗治疗进展期胃癌34例

IMRT combined thermo-chemotherapy treatment of advanced gastric cancer of 34 cases

目的:研究调强适形放射治疗(IMRT)联合热、化疗治疗进展期胃癌的临床疗效。方法:对85例进展期胃癌患者采用方差分析单纯采用IMRT与联合热疗、联合热化疗的差异,并分析放疗量效之间的关系、微波热疗次数与疗效的关系。结果:单纯IMRT治疗有效率为47.62%,IMRT联合热疗有效率为56.67%,IMRT联合热、化疗有效率为73.53%;放射治疗量DT<40Gy有效率为56.00%,DT40～60Gy有效率为62.68%,DT≥60Gy有效率为72.41%;微波热疗<4次有效率为46.67%;微波热疗≥4次有效率为76.48%。经统计学处理,IMRT联合热化疗治疗组比单纯IMRT组有效率明显提高,差异有显著性(P<0.05);IMRT联合热疗组比单纯IMRT组有效率有所提高,但两组之间差异无显著性(P>0.05);DT为≥60Gy组比DT<40组有效率明显提高,差异有显著性(P<0.05);DT为40～60Gy组比DT<40组有效率有所提高,但两组之间差异无显著性(P>0.05)。结论:IMRT联合热、化疗能更有效的控制进展期胃癌发展;一定条件下,放射剂量越高治疗效果越好;在病人身体能耐受的前提下,微波热疗次数与疗效呈正相关。

Objective：To study the intensity modulated radiation therapy IMRT combined heat and chemotherapy treatment of advanced gastric cancer. Methods：85 cases of advanced gastric cancer treated with IMRT using a simple analysis of variance with the Joint hyperthermia, chemotherapy combined thermal differences and analysis of radiation dose-effect relationship between the frequency of microwave hyperthermia and the relationship between efficacy. Results：IMRT treatment efficiency was 47. 62%, tMRT combined heat treatment efficiency was 56.67%, IMRT combined heat and chemotherapy response rate was 73.53% ; radiation therapy volume DT〈40Gy efficiency was 56.00%, DT40 - 60Gy efficiency was 62.68%, DT ≥ 60Gy to 72. 41% efficient; microwave hyperthermia 〈4 times the effective rate was 46.67%; microwave hyperthermia ≥ 4 times the effective rate was 76. 48%. Statistical analysis, IMRT combined thermo-chemotherapy treatment group than simple group efficient IMRT significantly improved, there was significant difference （P〈0. 05）; IMRT combined therapy group than the simple efficiency of IMRT group has increased, but between the two groups There was no significant difference （P〉0.05） ; DT group ≥ 60Gy for DT 〈40 group was markedly improved, there was significant difference （P〈0.05）; DT for 40 - 60Gy group DT 〈40 group efficiency increased, but the difference between the two groups was not significant （P〉0. 05）. Conclusion： IMRT combined heat and chemotherapy can more effectively control the development of advanced gastric cancer; certain conditions, the higher the treatment dose, the better; in the patient＇s body can tolerate, under the premise of the number of microwave hyperthermia was positively correlated with the effect.