论文部分内容阅读
目的 分析甲状腺癌术后放射治疗疗效。方法 1978年 6月至 1986年 6月收治的甲状腺术后患者 10 0例 ,年龄 7～ 65岁 ,平均年龄 3 5岁。术后估计切除干净行预防性放疗 2 8例 ,术后残余癌行放疗 72例。所有病例均有术后病理诊断。全组均采用60 Co -γ线外照射 ,部分患者加用深度X线照射 ;术后行预防性放疗者 ,照射野包括原病变局部和瘤床区。对分化程度低 ,有淋巴结转移者 ,设野靶区自扩大包括双颈 ,病变达胸骨后上份者包括上纵隔。每天照射肿瘤量 1 8～ 2Gy ,每周照射 5次。本组实照肿瘤量为 3 4 8～ 65 2 5Gy/3 5～ 6 5周。对残余癌者放疗剂量高。 结果 本组随访率为 97% ,生存期从放疗日起计算 ,5 ,10 ,15年生存率分别为 90 % ( 90 /10 0 ) ,67% ( 67/10 0 )和 5 0 % ( 3 0 /60 )。结论 甲状腺癌首选手术治疗。术后残余癌加用放疗可提高疗效 ,甲状腺癌有淋巴结转移者长期生存差。甲状腺癌术后放疗肿瘤量以 40～ 60Gy/4～ 6周为宜。照射剂量应根据病理类型、病变范围、淋巴结转移情况及年龄等因素综合考虑。
Objective To analyze the effect of postoperative radiotherapy for thyroid cancer. Methods A total of 100 patients undergoing thyroidectomy from June 1978 to June 1986 were aged from 7 to 65 years with an average age of 35 years. After surgery, 28 patients underwent prophylactic radiotherapy and 28 patients received postoperative radiotherapy. All cases had postoperative pathological diagnosis. All patients were treated with 60 Co-γ radiation. Some patients were treated with deep X-rays. Prophylactic radiotherapy was performed after the operation. The radiation field included the original lesion and the tumor bed area. For those with low degree of differentiation and with lymph node metastasis, the target area is self-expanded to include two necks, and the lesions up to the upper part of the sternum include the upper mediastinum. The amount of tumor irradiating each day was 18 to 2 Gy, and it was irradiated 5 times per week. The actual amount of tumor in this group was 384–6525Gy/3 5–6 weeks. The dose of radiotherapy to residual cancer is high. Results The follow-up rate of this group was 97%. The survival period was calculated from the date of radiotherapy. The 5, 10 and 15 year survival rates were 90% (90/10 0), 67% (67/10 0) and 50% (3) respectively. 0 / 60). Conclusion Thyroid cancer is the first choice for surgery. Postoperative residual cancer plus radiotherapy can improve the efficacy of thyroid cancer, lymph node metastasis, poor long-term survival. Thyroid cancer postoperative radiotherapy tumor volume 40 ~ 60Gy / 4 ~ 6 weeks is appropriate. The radiation dose should be comprehensively considered based on the pathological type, extent of disease, lymph node metastasis, and age.