目的:探讨多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响。方法:选取收治的103例行胃癌根治术的患者,将所有患者随机分为甲乙丙三组,其中甲组患者34例,均采用多野照射治疗;而乙组患者也是34例,均使用三维适形放疗;丙组患者则有35例,均使用调强放疗。观察比较各组患者放疗后的上腹部症状改善情况,并且检测各组患者的肝功能和血常规以及胰淀粉酶等临床指标,比较各组患者经治疗后的复发率以及生存率。结果:甲组患者的近期疗效显著低于乙组患者(P<0.05),而乙组患者的近期疗效则明显低于丙组患者(P<0.05);三组患者的钡餐造影均有所改善,但是其组间比较差异不具有统计学意义(÷2=9.012,P>0.05)。甲组的不良反应率显著高于乙组和丙组(均P<0.05),并且各组患者的不良反应中血常规异常的发生率显著高于肝功能和胰脏功能的异常(均P<0.05),同时甲组患者出现放射性脊髓病的患者明显多于乙组(P<0.05),仅丙组患者未见放射性脊髓病。随访三年间三组患者第一年随访生存率无明显差异(P>0.05),而在第2年至第3年则三组患者的随访生存率有明显差异(均P<0.05),其中随访生存率以丙组患者最高,其次为乙组患者;另外随访三年间甲组患者的随访复发率显著高于乙组和丙组患者(均P<0.05),其复发率由低至高依次为丙组<乙组<甲组。结论:与多野照射治疗相比,三维适形放疗和调强放疗均能够更好地降低对胃癌周围组织的损伤和改善患者的临床症状,并且不良反应发生率低,对于降低复发率和提高生存率方面亦有不错的效果。 Objective: To investigate the effect of multi-field irradiation, three-dimensional conformal radiotherapy and intensity modulated radiotherapy on peri-cancer tissue in patients with gastric cancer. Methods: A total of 103 patients undergoing radical gastrectomy were enrolled in this study. All patients were randomly divided into three groups: group A and group B, 34 cases were treated with multi-field irradiation; group B was 34 cases, Radiotherapy; Group C, there are 35 cases, are using IMRT. The improvement of upper abdominal symptom after radiotherapy was observed and compared in all groups. The liver function, blood routine, pancreatic amylase and other clinical indexes of each group were compared. The relapse rate and survival rate of each group were compared. Results: The short-term curative effect of group A was significantly lower than that of group B (P <0.05), while the short-term curative effect of group B was significantly lower than that of group C (P <0.05). Barium meal was improved in all three groups , But the difference between the groups was not statistically significant (÷ 2 = 9.012, P> 0.05). Adverse reaction rate in group A was significantly higher than that in group B and group C (all P <0.05), and the incidence of abnormal blood tests in patients with adverse reactions was significantly higher than that in liver and pancreas (all P < 0.05). At the same time, there were more patients with radioactive myelopathy in group A than those in group B (P <0.05). Only group C did not have radiation-induced spinal cord disease. The three-year follow-up of the three groups had no significant difference in the first-year follow-up survival rates (P> 0.05), while in the second year to the third year the follow-up survival rates of the three groups were significantly different (all P <0.05) Survival rate was the highest in group C, followed by group B. In the other three years follow-up, the recurrence rate of group A was significantly higher than that of group B and group C (all P <0.05), and the recurrence rate was C Group