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目的研究６０Ｃｏ和电子线匹配作全胸膜放射治疗胸膜转移伴恶性胸水。方法２５例恶性胸水患者接受治疗。其中肺癌伴恶性胸水２０例，乳腺癌术后胸膜转移伴胸水３例，恶性胸腺瘤术后胸膜转移伴胸水２例。６０Ｃｏ野包括全肺，中央铅块屏蔽，屏蔽处照射电子束，计算中平面胸膜受量，１００％等剂量线为２Ｇｙ，常规照射１５次。可见肿瘤局部加量２０Ｇｙ／１０ＦＸ。中平面约２／３肺组织受量＜５０％。同时接受３～６个疗程化疗。结果２５例恶性胸水完全控制１７例，部分控制７例，总有效率９６％。２２例可见肿瘤３例完全消退，１７例部分消退。经随访，１例无瘤生存１４个月，２例１２个月，１６例４～１１个月。６例死亡，中位生存期９个月。胸水复发４例，总控制率为８０．０％。照射后患者血象较前下降，急性放射性食管炎（Ⅰ～Ⅱ级）１１例，２例胸膜明显增厚伴纤维化。结论６０Ｃｏ和电子线混合照射全胸膜临床上安全且具有较好的疗效
OBJECTIVE: To study the use of 60Co and electron wire matching for total pleural radiotherapy for pleural metastasis with malignant pleural effusion. Methods 25 patients with malignant pleural effusion received treatment. Among them, there were 20 cases of lung cancer with malignant pleural effusion, 3 cases of pleural metastasis with pleural effusion after breast cancer surgery, and 2 cases of pleural metastasis with pleural effusion following malignant thymoma surgery. The 60Co field includes whole lungs, central lead shielding, electron beam irradiation at the shield, calculation of midplane pleural load, 100% isodose dose 2Gy, conventional irradiation 15 times. It can be seen that the tumor local dosage 20Gy/10FX. About 2/3 of the lung tissue volume in the midplane is less than 50%. At the same time receive 3 to 6 courses of chemotherapy. Results Twenty-five cases of malignant pleural effusion were totally controlled in 17 cases, partial control in 7 cases, and total effective rate was 96%. Twenty-nine cases showed complete regression of tumors in 3 cases and partial regression in 17 cases. After follow-up, 1 patient survived for 14 months without tumor, 2 patients with 12 months, 16 patients with 4 to 11 months. Six patients died and the median survival period was 9 months. 4 cases of pleural effusion recurrence, the total control rate was 80.0%. After the irradiation, the patient’s blood was decreased. There were 11 cases of acute radiation esophagitis (Grades I-II), and 2 cases of pleural thickening were associated with fibrosis. Conclusions The combined use of 60Co and electron beam in the treatment of total pleura is safe and has good clinical efficacy