胸部肿瘤的立体定向放射治疗

The Fractionated Stereotactic Radiotherapy for Chest Tumors

目的:胸部肿瘤立体定向放疗的应用研究。方法:1999年11月至2001年1月期间共治疗41例患者45个病灶。进行分次立体定向适形放疗。射野一般4～8个,每日1次,连续照射,共5～12次,每次治疗时根据85%～95%剂量曲线确定处方剂量:4～7Gy,总量为25～60Gy。结果:41例45个病灶根据CT复查肿瘤消退情况确定CR为37.8%,PR为37.8%,总有效率为75.6%。结论:立体定向放疗治疗胸部较小的原发肺癌和孤立转移瘤是一种局部控制好、疗程短、疗效显著、无痛苦的新疗法;是常规大野放疗后局部追加剂量的最好方式;对于肺癌术后或放疗后复发,是减少肿瘤周围正常组织接受剂量,避免损伤,提高肿瘤局部控制率的有效手段。后期不良反应及远期疗效有待进一步观察。

Objective:To investigate the effect of chest tumors treated by fractionated stereotactic radiotherapy(SRT).Methods:From November1999to January2000,41patients with45solitary lesions in chest received SRT for25～60Gy /5-12f/5～12days;the fractionated dose was based on85%～95%dose curve ranging from4～7Gy.Results:The CT results showed that the CR,PR and CR+PR of45solitary lesions in the41patients treated by SRT were37.8%,37.8%and75.6%respectively.Conclusion:The SRT for small chest tumors including small metastases is a new effective method and it can improve the local control rate.The thera-peutic course is shortened and no any side effects are to be found.It is also a better choice for improving the local dose for those patients after routine radiotherapy.Because of the lowering ra-diation dose to adja cent structures,the SRT can be used in treating the recurrent lung cancer patients after surgery or radiotherapy.The late side-effects and long-term effect of SRT should be observed.