摘要
目的:总结3年来我科经病理证实的高龄中晚期胃癌患者接受三维适形放疗的长期随访数据,评价姑息性三维适形放射治疗对中晚期胃癌的价值。方法:回顾性分析我科2010年1月-2012年12月三维适形放疗的68例高龄中晚期胃癌患者的病理分期、放疗的靶区和剂量、放疗后病灶控制的情况、复发转移的情况及生存时间。结果:本组患者男44例,女24例,年龄54-83岁(平均64岁)。病理分期为T2-4N1-3M0-1。全部患者采用直线加速器三维适形放疗。放射靶区为胃癌病灶及胃左动脉淋巴结,放疗总剂量45-55Gy,6MV或15MV-X射线,每次2.0-2.5Gy,18-22次,每周5次。放疗后1-3个月86.4%(19/22)患者进食困难明显减轻或正常进食;91.3%(42/46)患者上腹部疼痛明显减轻。胃镜提示39.7%(27/68)患者胃部病灶缩小甚至消失;72.1%(49/68)患者腹部CT提示胃部病灶及胃左淋巴结缩小。放疗后CR 16.2%(11/68),PR61.7%(42/68)。本组患者生存期为3-18个月,中位生存期为13.5个月。放疗后4.4%(3/68)患者有轻-中度胃痛。结论:对中晚期胃癌三维适形放疗具有与手术类似的控癌作用,又能避免手术引起的创伤等不良反应,尤其是对已有周围脏器浸润的高龄、体质差的中晚期患者姑息性三维适形放射治疗可起到局部肿瘤控制、镇痛、改善生存质量、延长生存期的作用。但姑息性三维适形放疗的靶区确定、治疗剂量的选择以及综合治疗方面尚需进一步研究。
Objective：To retrospectively study the follow - up data of 68 elder advanced gastric caicinoma patients who accepted three dimensional eonformal radiotherapy. Methods：From 2010 to 2012,68 elder gastric carcinoma pa- tients were treated in our centre. The pathology staging,target and dose of three dimensional conformal radiotherapy, local lesion control, recurrence and metastasis, and survival time were summarized. Results：Patients included male 44,female 24,average 64 years（54 -83 years）. The pathology stage was T2-4N1-3M0-1 . All patients were treated by linear accelerator three dimensional corformal radiotherapy, gross tumor volume （GTV） included gasrtic lesion and left gastric artery node. Total dose was 45 - 55Gy, 6 megavolt or 15 megavolt X - ray, sigle dose 2.0 - 2.5Gy, 18 - 22 fractions,5 fractions per week. After radiotherapy 1 -3 months,86.4% （19/22） patients who sufferd from food ob- struction dispalyed notable alleviation or eating smooth,91.3% （42/46） patients who sufferd from upper abdomen pain displayed pain degree lessen or pain relieved;39.7% （27/68） cases displayed that gastric lesion diminution un- der gastroseopes;72.1% （49/68） cases showed that stomach lesion and left gastric artery node diminution or regres- sion under abdomal computerized tomography. The complete remission rate（CR） was 16.2% （11/68） ,and partial re- mission rate（PR） was 61.7% （42/68） . The life span was 3 - 18 months and median life span was 13.5 months. Ouly 4.4% （3/68） cases had mild or moderately stomachache or anorexia. Conclusion：Three dimensional conformal radiotherapy performed antieaneer effects as same as surgery in advanced gastric carcinoma,and avoiding serious com- plication related to injury of surgical operation. Especially,palliative three dimensional conformal radiotherapy dis- played significantly analgesia,imporving quality of life and extending life span in elder patients who had surroundingorgans infiltration and distant metastasis. However,the defination of GTV, and dose of palliative three dimensional con- formal radiotherapy and combination with other therapy need further investigation.
出处
《现代肿瘤医学》
CAS
2014年第3期603-606,共4页
Journal of Modern Oncology
关键词
高龄患者
中晚期胃癌
三维适形放疗
姑息性治疗
elder patients
advanced gastric carcinoma
three dilnensional conformal radiotherapy
palliative radio-therapy
