伽玛刀联合替吉奥治疗腹腔淋巴结转移癌近期疗效观察

Short-term effectiveness of gamma knife radiosurgery combined with S-1 for metastasis of retroperitoneal lymph nodes

目的评价伽玛刀联合替吉奥(S-1)治疗腹腔淋巴结转移癌患者的近期疗效。方法采用伽玛刀联合替吉奥治疗腹腔淋巴结转移癌患者38例,根据病变大小和部位选用不同大小的准直器,50%～70%等剂量曲线覆盖整个靶区,单次周边剂量给予3～5 Gy,周边总剂量30～45 Gy,分割8～14次,每周3～5次。替吉奥胶囊(S-1):60～80 mg·m-2·d-1,每天2次,服用2周后停药1周,每3周为1个周期,至少2周期。结果 36例疼痛患者治疗前疼痛强度评估NRS(数字评估法)为(5.23±1.04),治疗后NRS为(1.02±0.33)(P<0.05),CR8例,PR20例,总有效率(CR+PR)为73.6%。随访6个月、12月、18月,生存率分别为84.2%,42.1%,28.9%。结论伽玛刀联合替吉奥治疗腹腔淋巴结转移癌安全有效,可作为腹腔淋巴结转移癌患者新的治疗手段。

Objective To evaluate the short-term therapeutic effectiveness of metastasis of retroperitoneal lymph nodes with gamma knife radiosurgery combined with S-1.Methods Thirty-eight cases with metastasis of retroperitoneal lymph nodes were treated by gamma knife radiosurgery combined with S-1.According to the size and location of the tumors,different diameters of collimator helmets were used.The radiosurgery plan was designed to cover whole target area at isodose curves of 50%～70% with a margin dose of 3-5 Gy each time and the total margin dose of 30～45Gy,which was carried out at a frequency of 3～5 times each week.S-1 capsule 60～80 mg·m-2·d-1was given orally twice daily for 2 weeks.The chemotherapy was repeated every 3 weeks.All the patients received 2 cycles at least of S-1.Results The pain intensity measured by numerial rating scale decreased from（5.23±1.04） to（1.02±0.33）within four weeks after treatment（P0.05）.There were 8 cases of CR and 20 of PR.The response rate was 73.6%（CR ＋ PR）.The survival rate was 84.2%,42.1%,28.9% in the follow-up time of 6 months,12 months and 18 months respectively.Conclusions Gamma knife radiosurgery combined with S-1 is an effective and safe treatment in metastasis of retroperitoneal lymph nodes.