胃癌术后不同放疗的疗效及对周围组织影响的比较研究

Postoperative radiation therapy of gastric cancer and the comparative study of the different impact on the surrounding tissues

目的比较多野照射、三维适形放疗(3DCRT)及调强适形放疗(IMRT)的早期、长期疗效及对周围组织的损伤情况。方法 120例胃癌术后患者随机分为多野照射组(A组)、3DCRT组(B组)和IMRT组(C组),放疗结束后比较三组患者症状缓解情况、钡餐造影改善情况、血常规、肝功能、胰淀粉酶、以及三年内的生存率和复发率,晚期迟发性放射性脊髓病的发病率。结果三种放疗方法对胃癌术后的疗效均可排序为C>B>A,对周围组织脏器的影响程度C<B<A,且除钡餐结果外,其余指标B组、C组与A组相比均有显著性差异(P<0.05)。结论 3DCRT和IMRT较普通多野照射能更好提高胃癌疗效,且IMRT优于3DCRT。

【Objective】 To compare multi-field radiation therapy,three dimensional conformal radiation therapy（3D2CRT） and intensity-modulated radiotherapy（IMRT） on their curative effects and the damage effects to surrounding tissues.【Methods】 120 patients with gastric cancer were randomly treated with multi-field radiation therapy,3D2CRT and IMRT after operation.Compare symptomatic relief,barium meal results,blood routine,hepatic function,amylopsin,survival rate and relapse rate during three years,as well as incidence rate of tardive radiative myelopathy.【Results】 Curative effects of three therapy methods can be ranked as C〉B〉A,whereas the damage influences to surrounding tissues can be ranked as C〈B〈A.The entire index except barium meal results are significantly different between group B,C and A（P〈0.05）.【Conclusion】 Compared with multi-field radiation therapy,3D2CRT and IMRT can improve curative effects,and IMRT is better than 3D2CRT.