肿瘤术前加速分割放疗的临床应用

Preoperative Accelerated Fractional Radiotherapy in Malignant Tumor

目的介绍肿瘤患者术前加速分割照射技术及近期疗效。方法从１９９５年６月至１９９８年１０月共计５２例患者接受了这种术前加速分割放疗。其中有宫颈癌３１例；直肠癌１０例；舌体癌６例；食管癌３例以及肺癌２例。治疗除舌癌采用４ＭＶ－Ｘ线外，其余均使用１０ＭＶ－Ｘ线照射。照射区域包括原发肿瘤加局部淋巴引流区。照射野为两野等中心对穿照射。每日 ３Ｇｙ，共计３０Ｇｙ／１０次／２周。放疗结束后 ２～４周行手术切除术。结果 ５２例患者对这种治疗均表现出良好的耐受性。无一例患者因急性放射反应而中断治疗。放疗结束后的术前检查显示肿瘤较放疗前均有不同程度缩小或与周围正常组织的粘连减轻。其中４５例有了手术适应症并行了手术切除术。放疗后的手术切除率为８６，５％。术中操作顺利，无严重出血及粘连。术后伤口愈合良好，无并发症发生。结论肿瘤术前加速分割放疗与常规放疗即４０Ｇｙ／２０次／４周相比较，具有放疗时间短以缩短放疗──手术──放疗的总治疗时间，对手术无影响。近期疗效令人满意。远期效果还需进一步随访评价。

Objective:To present the primary result and the techniaue of preoperative accelerated fractional radiotherapy in malignant tu- mor. Methods: From 1995 June to October 1998, 52 patients with malignant tumor were treated using the technique of preoperative accelerated frac tional radiotherapy. Among the patients, there are 31 cases with cervix cancer; 10 rectum cancer; 6 tongue cancer; 3 esophageal cancer and 2 lung cancer, The patients were irradiated were 4MV-X or 10MV-X photon 3 Gy per day, total tumor dose is 30 Gy/10 frationds/2 weeks. 7he operations were carried at in 2 - 4 weeks. Results: An patients showed tolerance to the treatment. No treatment was broken due to acute radiation reac tions. The preoperative examinations showed more or less the reduction of tumors and the alleviation of adhesion. 45 cases received operative treat- ment and the rate of operation is 86. 5 % .The operation was easy and no cmplication. Conclusions:Compared with conventional irradiation of 40 Gy/20F/4W, the tecnique possesses short treatment time and no influence upon operation. Primary results are satisfactory and long-term follow- up should be carried on.