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目的 :研究Ⅱ、Ⅲ期肾癌术后放疗的作用。方法 :1992年 1月— 1995年 1月 ,35例Ⅱ和Ⅲ期肾癌行术后放疗。照射范围包括肾瘤床、肾蒂、主动脉旁及下腔静脉旁淋巴结区 ,运用TPS技术 ,采用直线加速器 18MVX线照射 ,DT 45— 5 0Gy 5周。结果 :失访 2例按死亡处理 ,随访率 94.4% ,全组无复发病例 ,三年及五年生存率各为5 7% ( 2 0 35 )和 45 .7% ( 16 35 )。三年生存率Ⅱ期为 6 9.2 % ( 9 13)、Ⅲ期为 5 0 % ( 11 2 2 ) ,五年生存率Ⅱ期为 5 3.8% ( 7 13)、Ⅲ期为 41% ( 9 2 2 )。 88.2 % ( 15 17)死于远处转移。结论 :Ⅱ、Ⅲ期肾癌患者术后放疗可以改善生存 ,远处转移是肾癌治疗失败的主要原因
Objective: To study the effect of postoperative radiotherapy for stage Ⅱ and Ⅲ renal cell carcinoma. Methods: From January 1992 to January 1995, 35 patients with stage II and III renal cancer underwent postoperative radiotherapy. Irradiation range includes nephrotic bed, renal pedicle, para-aortic and paraventricular lymph node area. Using TPS technique, linear accelerator 18MVX was used to irradiate DT 45-500 Gy for 5 weeks. Results: Two cases were lost to follow-up. The follow-up rate was 94.4%. No recurrence was found in the whole group. The three-year and five-year survival rates were 57% (2035) and 45.7% (1635) respectively. The three-year survival rate was 62.2% (91%) in stage II, 50% (1122) in stage III, 5 3.8% (713) in stage II and 41% in stage III 2 ). 88.2% (15 17) died of distant metastasis. Conclusions: Postoperative radiotherapy for patients with stage II and III renal cancer can improve survival and distant metastasis is the main reason for the failure of treatment of renal cell carcinoma