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恶性肿瘤术后放疗的效果不能令人满意,近来多数学者倾向于术前放疗,其理由是: 1.术前放疗可以有效杀灭瘤周含氧丰富,增殖迅速的瘤细胞及亚临床灶,使瘤体缩小,放疗后位于肿瘤中央残存的乏氧瘤细胞可被手术切除。 2.降低瘤细胞的活力,使瘤周血管和淋巴管闭塞,减少因手术操作引起的瘤细胞局部种植或远处转移的危险。 3.控制手术野外的转移淋巴结。 4.可以缩小手术范围,使治疗后患者保持较好的生理功能和生活能力。 术前放疗的主要顾忌是增加手术的困难(如出血、粘连)和影响切口愈合,但如术前放疗剂量适宜,手术间隔时间合理,可减少某些病例的手术困难,亦不增加术后并发症。
The effect of postoperative radiotherapy for malignant tumors is not satisfactory. Most scholars tend to preoperative radiotherapy in recent years. The reasons are as follows: 1. Preoperative radiotherapy can effectively kill tumor cells with rich oxygen, rapid proliferation, and subclinical lesions. The tumor is shrunk, and the hypoxic tumor cells remaining in the center of the tumor after radiotherapy can be surgically removed. 2. Decrease the viability of tumor cells, occlude the peripheral blood vessels and lymph vessels, and reduce the risk of localized or distant metastasis of tumor cells caused by surgical operations. 3. Control the metastatic lymph nodes in the surgical field. 4. The scope of surgery can be reduced, so that patients can maintain good physiological function and living ability after treatment. The main concern of preoperative radiotherapy is to increase the difficulty of operation (such as bleeding, adhesions) and affect incision healing, but if the preoperative radiotherapy dose is appropriate and the interval between surgery is reasonable, it can reduce the difficulty of surgery in some cases and does not increase postoperative concurrency. disease.