立体放射深部加温治疗体部肿瘤临床疗效观察

Clinical effect of stereotactic radiotherapy combined with radiofrequency diathermy for malignant tumor

目的 探讨体部肿瘤立体放射治疗质量 ,减少治疗并发症和不良反应 ,分析联合射频 (深部热疗 )综合治疗疗效。方法 对 2 96例 (319个病灶靶点 )的患者采用立体定向放射治疗 ,其中肝癌 70例 ,肺癌 113例 ,肾癌 6例 ,盆腔腹膜后淋巴转移 (肿块 ) 36例 ,骨肿瘤 2 6例 ,胰头癌 2 3例 ,肝胆管癌 16例 ,卵巢癌 6例。随机分组 ,单纯 3D立体治疗 196例 ,联合射频热疗或化疗药物胸腹腔灌注后加温治疗10 0例。在 3D立体治疗计划制定过程中 ,采用优化选择 (3～ 6次 ) ,根据瘤体的部位不同 ,适当调整CTV ,并对瘤体较大的病灶采用单次减量的方法。结果 降低了治疗并发症和对重要脏器的损伤 ,提高了生活质量。结论 临床实践证明 ,根据不同病情、不同部位和个体差异正确计划治疗剂量和CTV瘤体部位的适当校正 ,特别是中、晚期肿瘤 。

Objective To improve the effect of stereotactic radiotherapy for malignant tumor and reduce the complication and to analyse the effect of combined stereotatic radiotherapy with radiofrequency(deep diathermy).Methods 296 patients(319 target volumes)were treated by stereotactic radiotherapy,which include liver cancer 70,lung cancer 113,renal cell carcinoma 6,retro pelviperitoneal lymphatic metastasis 36,bone tumor 26,pancretic cancer 23,liver bile duct cancer 16,ovarian carcinoma 6.These patients were divided into two groups random,196 patients were treated by stereotactic radiotherapy single,100 patients were treated by combined stereotactic radiotherapy with radiofrequency diathermy directly or after peritoneal or pectoral cavity chemotherapy drug perfusion.When made the 3D therapy plan according to different regions,and adjusted CTV and reduced the dose per time to big tumor and chose the best plan(3～6 times).Results The complications and the damage to the important organ were reduced and the living quality by combined stereotactic radiotherapy with radiofrequency diathermy were improved.Conclusion It’s important to choose correct dose and adjust CTV,according to different disease,region and individual differences.Especially to those patients with advanced tumor,it is significant to treat with combined stereotactic radiotherapy with radiofrequency diathermy in clinic.