三维立体适形放射治疗腹腔转移性腺癌22例分析

Analysis of 22 patients with abdominal metastatic adenocarcinoma radiotherapy using 3-dimensional stereotactic conformal radiotherapy

目的 :研究腹腔转移性腺癌用三维立体适形放疗的可行性。方法 :对 2 2例腹腔转移性腺癌病例作三维立体适形放疗。设非共面同中心照射野 6～ 8个 ,靶区剂量 2 0～ 30Gy ,7～ 9天。其中 8例加常规放疗 ,30～ 4 0Gy ,2 1～ 2 8天。结果 :临床症状缓解率为 97 7% ,肿块有不同程度退缩 ,总有效率为 77 3% (17/ 2 2 )。治疗前肿块体积小于 5cm× 5cm× 5cm者疗效明显优于大于 5cm× 5cm× 5cm者 (P <0 0 2 5 )。中位生存月数为 7个月 ,1年生存率达 2 2 7% (5 / 2 2 )。加常规照射者疗效无明显提高 (P >0 1) ,放射性损伤却明显增加 ,总体损伤率为 18 1% (4/ 2 2 )。结论 :大多数患者可以耐受三维立体适形放疗 ,通过治疗可改善生存质量 ,适当延长生存期 ,但加用常规照射并不能提高疗效 。

Objective:To study the possibility of using 3 dimensional stereotactic conformal radiotherapy on abdominal metastatic adenocarcinoma.Methods:22 patients with abdominal metastatic adenocarcinoma received 3 dimensional stereotactic conformal radiotherapy. Irradiation fielded had 6～8. The dose was 20～30 Gy, 7～9 d, 8 of these patients combined normal radiation at the same time, and the dose was 30～40 Gy, 21～28 d.Results:97 7% patients of clinical symptoms were relieved after treatment. The tumor became smaller in different level (CR 4, PR 13, NC5) and the total effect was 77 3% (17/22). The effect to patients with a tumor smaller than 5 cm×5 cm×5 cm is significantly better than those with a tumor bigger than 5 cm×5 cm×5 cm. The median survival time was 7 months. 1 year survival rate was 22 7%(5/22). The overall damage rate was 18 1%(4/22).Conclusion:3 dimensional stereotatic conformal radiotherapy may be effective in improving the life quality and in prolonging the life expectancy. But combining normal radiotherapy at the same time the radiational damage will increase significantly, instead of improvement of effect.