| 巨大肾母细胞瘤32例术前三维适形放疗效果分析 |
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| 引用本文： | 岳养军,李莎,魏世华,朱向辉,田种泽,陈小华. 巨大肾母细胞瘤32例术前三维适形放疗效果分析[J]. 肿瘤研究与临床, 2014, 0(4): 235-237,240 |
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| 作者姓名： | 岳养军 李莎 魏世华 朱向辉 田种泽 陈小华 |
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| 作者单位： | 兰州军区兰州总医院放射治疗科, 730050 |
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| 摘 要： | 目的 分析直径大于10 cm的巨大肾母细胞瘤术前三维适形放射治疗效果,探讨中晚期肾母细胞瘤更为有效的术前治疗方法.方法 32例患者均经影像学检查及穿刺活组织检查明确诊断,术前给予三维适形放射治疗,剂量分割方式：DT（150～200）cGy/次,5次/周,总剂量DT 800～2 000 cGy,中位剂量DT1 600 cGy.治疗中每周复查B型超声、CT测定肿瘤体积变化,患者一般情况好、肿瘤体积缩小1/3以上、肿瘤与毗邻重要脏器粘连缓解,及时请泌尿科会诊确定可以手术时,休息1周后行手术治疗.术中4例术中见有周围粘连者局部放置银夹标记,术后给予补充放疗DT1 000～2 000 cGy,中位剂量DT1 200 cGy.结果 瘤体中位缩减率37.0％,术前放疗有效率100.0％,完整切除率87.5％,无手术相关死亡率,2年无瘤生存率达84.4％（27/32）,5年无瘤生存率78.1％（25/32）.结论 巨大肾母细胞瘤术前三维适形放射治疗能缩小肿瘤,提高手术切除率,延长生存率.
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| 关 键 词： | 肾母细胞瘤 放射疗法,术前 预后 |
Efficacy analysis of preoperative 3-dimensional conformal radiotherapy in 32 cases of large nephroblastoma |
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| Affiliation: | Yue Yangjun, Li Sha, Wei Shihua, Zhu Xianghui, Tian Zhongze, Chen Xiaohuo( Department of Radiation Oncology, Lanzhou General Hospital, PLA, Lanzhou 730050, Chitin) |
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| Abstract: | Objective To analyse the effectiveness of the preoperative 3-dimensional conformal radiotherapy for large nephroblastoma up to 10 centimeters in diameter,and to investigate more effective preoperative therapies for intermediate and advanced nephroblastoma.Methods 32 cases of nephroblastoma were treated with preoperative radiotherapy with a dose fractionation as follows：150-200 cGy/fraction,5 fraction/week,the total dose of 1 000-2 000cGy,the mean dose of 1 600 cGy.During the radiotherapy,the B ultrasonic examination and CT were performed weekly to measure the variation of tumor volumes.The time of operation were determined based on the overall health status of patients,the shrinkage of tumor,and adhesions between tumor and adjacent vital organs.Radiontherapy was terminated one week before operation.4 patients who were found tumor adhered to normal tissues around kidney during operation were placed silver clip,and were given postoperative radiotherapy with additional dose of 1 000-2 000 cGy and the mean dose of 1 200 cGy.Results The median tumor reduction rate was 37 %.The effective rate of preoperative radiotherapy was 100 %.The complete resection rate was 87.5 %.2-years tumor-free survival rates was 84.4 % and 5-years was 78.1%.There was no surgery-related death.Conclusion Preoperative 3-dimensional conformal radiotherapy reduces tumor volume,and raises resection and survival rate. |
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| Keywords: | Nephroblastoma Radiotherapy Preoperative Prognosis |
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