肾上腺转移癌的立体定向放射治疗

目的探讨立体定向放射治疗肾上腺转移癌的临床可行性与近期疗效。方法采用OUR-QGD型立体定向体部伽玛射线放射治疗系统,治疗肾上腺转移癌43例,根据肿瘤的位置、临床靶体积、患者的身体状况与治疗目的,制定放疗计划及调整剂量分布。肿瘤体积7~1362 cm3,等剂量曲线50%~80%,周边照射总剂量3100~3600 cGy,分割处方剂量400~600 cGy,重复治疗6~9次,隔日治疗。结果治疗前腰背部疼痛28例,治疗结束后1~6个月,症状完全消失16例(57.1%),部分缓解10例(35.7%),2例无效(7.1%),疼痛缓解有效率为92.9%;43例肾上腺转移癌,共53个治疗病灶,治疗后3个月复查CT、MR或PET,肿瘤消失17例(32.1%),缩小27例(50.9%),无变化7例(13.2%),增大2例(3.8%),总有效率96.2%。结论立体定向放射治疗肾上腺转移癌临床效果确切,不良反应较轻。

Stereotactic radiotherapy for patients with adrenal metastasis

Objective To investigate the clinical application and the short-term effect of stereotactic radiotherapy in the patients with adrenal metastasis.Methods Forty-three patients with adrenal metastasis were treated with the stereotactic R-ray radiotherapy system.The radiotherapeutic planning and setting of dosage distribution were worked out on the basis of the carcinoma location,clinical target volume,therapeutic aim and health conditions of patients.The tumor volumes were 7-1362 cm3,the isodosge curve were 50%~80%,and the fractional doses were 400~600 cGy.The therapy was repeated 6~9 times for each patient,once in alternative days.Results In 28 patients with dorsoventral pain,3 months after treatment the symptom disappeared completely in 16 patients(57.1%),partial remittance in 10(35.7%),and no change in 2(7.1%) with a remission rate of 92.9%.In forty-three patients with 53 metastatic lesions,the tumor disappeared in 17 patients(32.1%),reduced in 27(50.9%),unchanged in 7(13.2%),and increased in 2(3.8%) with a response rate of 96.2%.Conclusion The clinical results of stereotactic radiotherapy for adrenal gland metastasis are definitive with mild side effect.