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[目的]探讨消化道肿瘤腹腔转移淋巴结适形放射治疗的价值。[方法]自2005年1月至2006年6月对56例消化道肿瘤腹腔转移淋巴结的患者进行三维适形放射治疗,95%等剂量曲线包绕计划靶区,每日一次,1.8～2Gy/次,40Gy后根据肿瘤情况缩野加量至总量50～60Gy,中位剂量56Gy。[结果]52例完成放疗计划,其中CR16例,PR22例,总有效率为(CR+PR)73.1%(38/52),1年生存率50.0%(24/48),2年生存率25.0%(12/48)。治疗后腹痛缓解率为90.6%(29/32),腹胀缓解率90.0%(18/20),腰背部疼痛缓解率96.7%(29/30)。急性消化道反应发生率为69.2%,白细胞减少发生率为21.2%。[结论]采用适形放射治疗消化道肿瘤腹腔转移淋巴结,具有治疗效果可靠、正常组织损伤轻、副作用小的优点,从而达到有效改善患者生活质量的目的。
[Objective] To investigate the value of conformal radiotherapy for peritoneal metastasis lymph nodes in gastrointestinal tumors. [Methods] From January 2005 to June 2006, 56 patients with peritoneal lymph node metastases from digestive tract tumors were treated with three-dimensional conformal radiotherapy. The 95% isodose curves were wound around the planned target area once a day with 1.8-2 Gy / Times, 40Gy according to tumor shrinkage plus amount to a total of 50 ~ 60Gy, the median dose of 56Gy. [Results] The complete radiotherapy plan was completed in 52 cases, of which CR16 and PR22 had a total effective rate of (CR + PR) 73.1% (38/52), a one-year survival rate of 50.0% (24/48), and a 2-year survival rate of 25.0 % (12/48). After treatment, the remission rate of abdominal pain was 90.6% (29/32), the remission rate of abdominal distension was 90.0% (18/20), and the relief rate of low back pain was 96.7% (29/30). The incidence of acute gastrointestinal reactions was 69.2%, the incidence of leukopenia was 21.2%. [Conclusion] The use of conformal radiotherapy in the peritoneal lymph node metastasis of gastrointestinal cancer has the advantages of reliable treatment, less damage to normal tissue and fewer side effects, so as to effectively improve the quality of life of patients.