三维适形放射治疗腹腔淋巴结转移癌23例临床观察.doc

三维适形放射治疗腹腔淋巴结转移癌23例临床观察[摘要] 目的 分析三维适形放射治疗腹腔淋巴结转移癌的近期疗效和放疗反应。方法 2005年5月～2008年11月采用分析三维适形放疗腹腔淋巴结转移癌23例,处方剂量2Gy/次,5次/周,总剂量48~60Gy。近期疗效按WHO实体肿瘤疗效标准评价,正常组织的放射反应按RTOG标准评价。结果 治疗结束后3个月,患者完全缓解(CR)6例,部分缓解(PR)13例,总有效率(PR+CR)为82.6%。近期疗效与病灶体积有关,病灶体积越小效果越好。鳞癌与腺癌的近期疗效相似。结论 三维适形放疗腹腔淋巴结转移癌有较好的近期疗效,放疗反应轻。 [关键词] 腹腔淋巴结; 转移; 适形; 放射治疗 [中图分类号] R730.55;R73-31 [文献标识码] A [文章编号] 1673-9701(2009)27-49-02 Three-dimensional Conformal Radiotherapy for Abdominal Lymph Node Metastases:Clinical Observation of 23 Cases JIANG Qinjuan WANG Dafei CHEN Shengdong Zhu Guomin Yixing Tumor Hospital,Jiangshu,Yixing 214206,China [Abstract] ObjectiveTo evaluate the feasibility of irradiation in abdominal lymph node metastases by using three-dimensional conformal radiotherapy and to assess the irradiation side effects. MethodsFrom May 2005 to Nov.2008,23 patients with abdominal lymph node metastases were treated by three-dimensional conformal radiotherapy. The total irradiation dose was 48~60 Gy,2.0 Gy per fraction over 4.8~6.0 weeks. The immediate response and side effects were evaluated according to the WHO and RTOG criterion system. ResultsThree months after irradiation,6 patients achieved complete remission(CR)and 13 patients achieved partial remission(PR). The total reponse rate(CR+PR)was 82.6%. The early response was related to the target volume. The smaller the target volume,the better the response. There was no significant difference in the early response between the squamous carcinomas and adenocarcinomas. ConclusionThe three-dimensional conformal radiotheraphy is an effective and feasible approach in the treatment of abdominal lymph node metastases. [Key words]Abdominal lymph nodes; Metastasis; Conformal; Radiotherapy 腹腔淋巴结转移癌在晚期恶性肿瘤尤其是消化道肿瘤中较为常见。患者出现腹痛、腰痛等症状,化疗效果不理想,严重影响患者的生活质量和生存期。我院放疗科2005年5月～2008年11月应用三维适形放疗技术治疗腹腔淋巴结转移癌患者23例,近期疗效较好,现报道如下。 1 资料与方法 1.1 一般资料 男性17例,女性6例,年龄38～83岁,中位年龄60岁。原发肿瘤部位:食管癌6例,贲门癌4例,胃癌9例,十二指肠癌1例,卵巢癌1例,宫颈癌1例,肝癌1例。原发病灶手术切除17例,放射治疗6例,病理类型:鳞癌7例,腺癌15例,其