三维适形放疗结合高强度聚焦超声治疗腹膜后淋巴结转移癌疗效观察.docVIP

三维适形放疗结合高强度聚焦超声治疗腹膜后淋巴结转移癌的疗效观察 　　【摘要】 目的 观察三维适形放疗（3DCRT）联合高强度聚焦超声（HIFU）治疗消化道恶性肿瘤腹膜后淋巴结转移的近期疗效。 　　方法 选择住院治疗的腹膜后淋巴结转移癌患者102例，采用抽签法分为3DCRT组和联合组各51例，3DCRT组给予3DCRT，联合组在3DCRT基础上加HIFU治疗，两组疗程均为3个月，比较两组淋巴结大小改变情况，治疗前后的疼痛评分、吗啡用量变化情况，治疗后患者的梗阻缓解情况、不良反应发生情况。 　　结果 两组淋巴结大小改变情况比较差异有统计学意义（P0.05），治疗后两组疼痛评分均显著下降（P0.05）。 　　结论 对腹腔淋巴结转移癌，3DCRT、HIFU联合治疗的近期疗效明显优于单纯的3DCRT，且不良反应少，临床应用价值较高。 　　【关键词】 淋巴转移；高强度聚焦超声；三维适形放疗 　　中图分类号：R735.4 文献标识码：A 　　【Abstract】 Objective To observe short-term curative effect of three dimensional conformal radiation therapy（3DCRT） combined with high intensity focused ultrasound （HIFU） in the treatment of retroperitoneal lymph node metastasis of malignant digestive tumor. 　　Methods 102 patients with retroperitoneal lymph nodes metastatic carcinoma，who received hospitalization were collected，and they were randomly divided into 3DCRT group and combination group with 51 cases in each group.The 3DCRT group were given 3DCRT，while the combination group were added HIFU based on the 3DCRT.Both groups were treated for 3 months.Then，changes of lymph node sizes，pain scores before and after treatment，changes of morphine doses，obstruction alleviation situation and occurrence of adverse reactions after treatment of the two groups were compared. 　　Results Difference of comparison of changes of lymph node sizes was statistically significant between groups（P0.05）.After treatment，pain scores of both groups significantly decreased （P0.05）. 　　Conclusion Curative effect of HIFU combined with 3DCRT is obviously superior to that of single use of 3DCRT in the treatment of retroperitoneal lymph nodes metastatic carcinoma.It has fewer adverse reactions and higher value of clinical application. 　　【Key words】 lymphatic metastasis；high intensity focused ultrasound；three-dimensional conformal radiation therapy 　　腹膜后淋巴结是中晚期消化道及盆腔恶性肿瘤常见转移部位，但该病早期无典型临床症状，因此大部分患者在检查发现时已进入晚期，此时肿瘤已侵入周围组织器官，其治疗难度大，手术切除成功率低[1]。此类患者机体免疫功能低下，不能耐受化疗治疗；而常规放疗易损伤肿瘤周围脏器，通常只能采取姑息性治疗[2]。为此，寻找一种更有效的治疗方法显得尤其重要。本研究对51例淋巴