立体定向适形放射治疗腹腔转移性腺癌31例临床分析

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目的研究立体定向放射治疗对腹腔转移性腺癌治疗的临床意义。方法对31例腹腔转移性腺癌病例作立体定向适形放疗。设同中心非共面照射野4 ̄7个,靶区剂量20 ̄35Gy,7 ̄9天。其中11例加常规放疗30 ̄40Gy,20 ̄25天。结果临床症状缓解率96.6%,肿块有不同程度的缩小,总有效率为77.4%(24/31)。治疗前肿块体积小于125cm3者明显优于大于125cm3者(P<0.025)。中位生存月数为11个月,一年生存率达25.8%(8/31)。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19.4%(6/31)。结论大多数患者可以耐受立体定向适形放射治疗,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,反而增加放射性损伤。 Objective To study the clinical significance of stereotactic radiotherapy in the treatment of metastatic adenocarcinoma of the abdominal cavity. Methods 31 patients with metastatic adenocarcinoma of the abdomen were treated with stereotactic conformal radiotherapy. Set with the center non-coplanar radiation field 4 to 7, the target dose of 20 ~ 35Gy, 7 ~ 9 days. Of which 11 cases with conventional radiotherapy 30 ~ 40Gy, 20 ~ 25 days. Results The clinical symptom remission rate was 96.6%. The tumor size was reduced to some extent. The total effective rate was 77.4% (24/31). Before treatment, the volume of tumor less than 125cm3 was significantly better than more than 125cm3 (P <0.025). The median survival month was 11 months, and the one-year survival rate was 25.8% (8/31). The effect of conventional irradiation was not significantly improved (P> 0.1), radioactive injury was significantly increased, the overall injury rate was 19.4% (6/31). Conclusion Most patients can tolerate stereotactic conformal radiotherapy. The treatment can improve the quality of life and prolong the survival time appropriately. However, the conventional radiotherapy can not improve the curative effect, but increase the radioactive injury.
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