论文部分内容阅读
目的:探讨PET/CT指导下的调强放射治疗用于治疗铂类耐药复发性卵巢上皮癌的临床价值。方法:经PET/CT全身扫描确定病变局限的铂类耐药复发性卵巢上皮癌36例,采取CT定位,分别在PET/CT和CT图像上勾画靶区,应用调强放射治疗,给予计划靶区的处方剂量为(50.4～64.8)Gy/(28～36)次,中位剂量为57.6Gy,1.8Gy/次,5次/周。观察患者的症状缓解、近期疗效、急慢性毒副作用及生存情况。结果:36例患者治疗结束后3个月,疼痛、阴道出血和下肢水肿等症状的完全缓解率分别为73.3%(11/15)、100.00%(7/7)和66.7%(4/6)。36例患者完全缓解33.3%、部分缓解13.9%、病情稳定27.8%,总有效率为47.2%。26例患者出现急性消化道反应,其中18例为Ⅰ级消化道反应,6例为Ⅱ级消化道反应,2例为Ⅲ级消化道反应;8例出现Ⅰ度骨髓抑制,2例出现Ⅱ度骨髓抑制;4例患者出现Ⅰ级慢性消化道反应。中位生存期20.3个月,中位无疾病进展生存期为10.1个月。结论:PET/CT指导下的调强放疗治疗复发病灶局限的铂类耐药卵巢上皮癌有较好的近期疗效,可延长患者的生存期,提高生活质量,毒副作用可以耐受。
Objective: To investigate the clinical value of IMRT guided by PET / CT in the treatment of platinum-resistant recurrent epithelial ovarian cancer. Methods: Thirty-six cases of platinum-resistant recurrent epithelial ovarian cancer were identified by PET / CT whole body scanning. The CT images were taken and the target areas were sketched on PET / CT and CT images respectively. IMRT was given to the planned target The prescribed dose in the district ranged from (50.4 ~ 64.8) Gy / (28 ~ 36), and the median dose was 57.6 Gy, 1.8 Gy / time, 5 times / week. Observe the patient’s symptoms, short-term efficacy, acute and chronic side effects and survival. Results: The complete remission rates of pain, vaginal bleeding and lower extremity edema were 73.3% (11/15), 100.00% (7/7) and 66.7% (4/6) in 36 patients 3 months after the end of treatment, . Thirty-six patients achieved complete remission of 33.3%, partial remission of 13.9%, stable condition of 27.8% and total effective rate of 47.2%. Twenty-six patients had acute digestive tract reactions, of which 18 were grade I digestive reactions, 6 were grade II gastrointestinal reactions, 2 were grade III gastrointestinal reactions, 8 were grade I myelosuppression, and 2 were grade II Myelosuppression; 4 patients with grade Ⅰ chronic gastrointestinal reactions. The median survival was 20.3 months, with a median progression-free survival of 10.1 months. Conclusion: IMRT-guided IMRT has a good short-term curative effect in the treatment of platinum-resistant epithelial ovarian cancer with limited recurrent lesions, which can prolong the survival of patients and improve the quality of life. The toxic side effects can be tolerated.