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[目的]比较局部晚期胃癌患者术后调强放疗(IMRT)与三维适形放疗(3D-CRT)计划,观察术后IMRT的不良反应及临床疗效。[方法]对46例局部晚期胃癌患者术后同时作IMRT及3D-CRT计划,处方剂量4500cGy,分割剂量180cGy。[结果]与3D-CRT相比,IMRT靶区剂量分布更好,平均剂量更高(P<0.05),肝脏平均受照剂量明显降低(P<0.05),左肾V12.5、V22.5亦显著降低(P<0.05)。46例患者1年及2年生存率分别为98.0%、80.0%,死亡的6例患者中有5例发生了远处转移。[结论]对局部晚期胃癌患者,相对3D-CRT,术后IMRT靶区剂量分布更好,临床不良反应可耐受。
[Objective] To compare the postoperative IMRT and 3D-CRT plans of patients with locally advanced gastric cancer and to observe the adverse reactions and the clinical effects of postoperative IMRT. [Method] 46 patients with locally advanced gastric cancer were treated with IMRT and 3D-CRT at the same time. The prescription dose was 4500cGy and the dose was 180cGy. [Results] Compared with 3D-CRT, the IMRT target dose distribution was better, the average dose was higher (P <0.05), the average liver irradiation dose was significantly lower (P <0.05), the left kidney V12.5, V22.5 Also significantly lower (P <0.05). One-year and two-year survival rates of 46 patients were 98.0% and 80.0%, respectively. Of the 6 patients who died, 5 patients had distant metastasis. [Conclusion] Compared with 3D-CRT, the IMRT target dose distribution is better in patients with locally advanced gastric cancer and the clinical adverse reactions are tolerable.