三维适形放射疗法联合高强度聚焦超声治疗腹膜后淋巴结转移癌疗效观察

Effect of three dimensional conformal radiation therapy combined with high intensity focused ultrasound on retroperitoneal lymph node metastases cancer

目的观察三维适形放射疗法（3D-CRT）联合高强度聚焦超声（HIFU）治疗腹膜后淋巴结转移癌的近期疗效。方法选择2002年10月至2010年12月山东省泰安市中心医院确诊为腹膜后淋巴结转移癌患者79例,其中39例患者采用3D-CRT联合HIFU治疗,40例采用单纯3D-CRT治疗。共治疗25~28次,总放射剂量50－56 Gy,配合HIFU治疗6－25次。观察两组患者淋巴结消退、梗阻缓解情况及不良反应。计算治疗总有效率并应用χ^2进行比较。结果 3D-CRT联合HIFU治疗组完全缓解率为59.0%（25/39）,部分缓解率为35.9%（14/39）,治疗总有效率为94.9%。单纯3D-CRT治疗组完全缓解率为32.5%（13/40）,部分缓解率为47.5%（19/40）,治疗总有效率为80.0%。两组治疗总有效率差异有统计学意义（χ2=4.230,P=0.032）。所有患者治疗时均未出现出血、胃肠道穿孔、皮肤烧伤等并发症。结论 3D-CRT联合HIFU治疗腹膜后淋巴结转移癌疗效明显,不良反应少,具有一定的临床应用价值。

Objective To observe the short-term effects of three dimensional conformal radiation therapy（ 3D-CRT） combined with high intensity focused ultrasound（ HIFU） in the treatment of retroperitoneal lymph node metastases tumors. Methods Senventy-nine patients diagnosed with retroperitoneal lymph node metastases tumors from October 2002 to December 2010 in Taian City Central Hospital were enrolled in this study. Thirty-nine cases received 3D-CRT combined with HIFU therapy,and other 40 cases received 3D-CRT only. Each patient endured 25-28 times treatment,and the total radiation dose were 50-56 Gy,and HIFU were 6-25 times. Lymph node recession and obstruction relief of the two groups were observed. The total effective rates were calculated and were compared with χ2test. Results In combined therapy group,the rates of complete response（ CR）,partial response（ PR） and total response（ TR） were 59. 0%（ 25/39）,35. 9%（ 14/39） and 94. 9%,and those in 3D-CRT group were 23. 5%（ 13/40）,47.5%（ 19/40） and 80.0%. There was significant difference between the two group（ χ^2= 4. 230,P = 0. 032）. No serious complications were observed such as bleeding,gastrointestinal perforation and skin burn. Conclusions 3D-CRT combined with HIFU has distinct curative effect and mild adverse reactions in the treatment of retroperitoneal lymph node metastases tumors. So it has certain clinica application value.