放射治疗诱发恶性肿瘤32例分析

32 cases of radiation induced malignant tumor

研究恶性肿瘤放射治疗后诱发恶性肿瘤的发生因素。方法 回顾性分析 2 9年中放射诱发的 32例恶性肿瘤 ,其中原发肿瘤是宫颈癌的 2 4例、鼻咽癌的 6例、上颌窦癌的 2例。放射源为6 0 Co或 8MVX射线 ,常规分割照射 ,照射剂量为 40～ 12 0Gy。 结果 32例放射治疗后 3～ 2 6年在原照射部位出现了肿瘤 ,其中 2 4例宫颈癌被诱发了直肠腺癌、臀部纤维肉瘤、膀胱移行细胞癌 ;6例鼻咽癌被诱发了硬腭鳞癌、软腭低分化腺癌、上颌窦骨肉瘤 ;2例上颌窦鳞癌被诱发了上颌骨骨肉瘤。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、照射部位有关。

Objective A probe was attempted at the possible etiologic factors of radiation induced malignant tumors.Methods A retrospective study was done on 32 cases of radiation induced malignancies of which the original cancers had been:carcinoma of uterine cervix 24 ,nasopharyngeal carcinoma 6 and cancer of the maxillary antrum 2. The initial radiotherapy was 60 Co or 8 MV X-ray,conventionally fractionated at doses of 40～120 Gy.Results After 3～26 years of the initial radiatherapy, 32 patients developed tumors within the portal. There were:rectal cancer, fibrosarcoma and transitional carcinoma of uninany bladder in the 24 cervical carcinomas,squamous carcinoma of hard palate,poorly differentiated adenocarcinoma of soft palate and osteosarcoma of the maxillary bone in the 6 nasopharyngeal carcinomas and osteosarcoma of the maxillary bone in the 2 cases of squamous carcinoma of the maxillary antrum.Conclusion The etiologic factors of radiotion induced malignancies are total dose, the age in which the initial radiotherapy was given and the site of radiotherapy.