盆腔短程姑息放疗在晚期直肠癌中的疗效观察

目的 评估盆腔短程姑息放疗在合并局部症状晚期直肠癌中的疗效及安全性,为晚期直肠癌姑息放疗提供治疗策略.方法 选取2016年5月-2020年4月就诊于浙江大学医学院附属金华医院共51例晚期直肠癌患者为研究对象.年龄为43～ 74岁,中位年龄为61岁;男性28例,女性23例;51例患者中合并疼痛、出血、肠梗阻比例分别为66...     

晚期贲门癌姑息性切除联合术后化疗的价值

目的探讨晚期贲门癌姑息性切除联合术后化疗的治疗效果及安全性。方法资料完整姑息性切除的166例晚期贲门癌患者，术后18—20d开始化疗，采用奥沙利铂130mg／m^2静脉滴注，第1天5-FU 500mg静脉推注，以后5一Fu2600mg／m^2连续48h静脉滴注，每4周1个疗程，3个疗程后评价化疗结果。结果全组无手术及化疗死亡病例，CR8例；PR68例；SD36例；PD54例。RR（PR＋CR）为43．4％；1．2，3年生存率分别为71％，43％及18％。不良反应主要有神经末稍反应、恶心、呕吐，无Ⅲ～Ⅳ度骨髓抑制。结论晚期贲门癌姑息性切除联合术后化疗安全，不良反应轻．有明显的近期效采．     

胸腺瘤的诊断与外科治疗

目的总结胸腺瘤的临床病理特点、手术方法及预后因素。方法66例胸腺瘤患者按Masaoka临床分期,根据肿瘤的生长情况确定术式,包括采用胸部正中切口或胸前外侧切口,完整或姑息切除胸腺瘤。结果在66例胸腺瘤中伴重症肌无力者14例（21．2％）,MasaokaⅠ期29例（43．9％）,Ⅱ期16例（24．2％）,Ⅲ期19例（28．8％）,Ⅳ期2例（3．0％）。全胸腺及胸腺瘤切除14例,单纯胸腺瘤切除40例,肿瘤部分切除5例,开胸探查肿瘤活检6例,颈部淋巴结活检1例。合并心包切除7例,上腔静脉部分切除2例,肺部分切除1例。术后30d内死亡1例,术后24例辅助放疗,2例辅助化疗,4例复发。结论胸腺瘤应尽量手术切除,即使不能完整切除,也应部分切除肿瘤,术后辅助放化疗。     

重新认识甲状腺未分化癌

目的正确认识甲状腺未分化癌的临床特点,探讨提高生存率的方法。方法回顾性分析了1981年3月~2005年7月在我院收治的58例甲状腺未分化癌及鳞癌患者的临床资料,其中行单纯手术(SA)25例,手术 术后放疗(S R)33例,放疗剂量40~70Gy。结果气管受侵40例(69·0%),食管受侵32例(55·2%),颈总动脉受侵17例(29·3%),发生淋巴结转移19例(32·8%)。所有甲状腺未分化癌患者1、3、5年生存率分别为37·8%、31·2%、25·9%。S R组5年生存率(37·8%)明显高于SA组(9·9%)(P=0·0000)。临床达到肉眼切除干净患者5年生存率(41·4%)也明显高于肿瘤残存的患者(12·4%)(P=0·0023)。术后放疗<60Gy组5年生存率(19·3%)明显低于≥60Gy组(53·7%)(P=0·0000)。原发灶复发或治疗后未控致死24例(61·5%)。结论甲状腺未分化癌预后很差,但根治性手术切除及术后≥60Gy放疗可提高其生存率。气管、食管及颈总动脉受侵是姑息切除肿瘤的主要原因,局部复发是主要的死亡原因。     

10-YEAR SURVIVAL RATE FOR PATIENT WITH NASOPHARYNGEAL CARCINOMA AFTER RADIATION THERAPY CLINICAL ANALYSIS OF 367 CASES

Of 1 344 patients with nasopharyngeal carcinoma treated during 1961-1965 at the Shanghai Cancer Hospital, 367 who sarvived over 10 years after radia- tion therapy, were analysed. The iesults showed that the patients with stage I , n nasopharyngeal carcinoma and those with stage Ⅲ, IV,the 10-year survival rates were 41.5% and 22.8% respectively, the overall 10-year survival rate being 27.3%. The 10-year survival rate was higher for female patients than for males, and was not related to the age of the patients and the pathological type of this carcinoma. The optimal tumor dosage was thought to be 60-70 Gy 350(95.4%) out of the 367 patients received radiotherapy only once. The rest received repeated irradiation for recurrence. For the reirradiated patients, the 10-year survival rate was 13.5%. Most recurrences occurred 5 years after radin- therapy(12 / 17), and only 5 within 3 years.     

Assessment of multimodality therapy for thymoma

Background This study was designed to analyze the accuracy and reliability of several prognostic indicators for long-term survival of thymoma patients. Methods Data from 142 patients treated for thymoma at the Tianjin Medical University Cancer Hospital from January 1954 to January 2001 were retrospectively analyzed. The Kaplan-Meier method and Cox＇s proportional hazards model test were used for single and multi-variable analyses respectively. The Log-rank test was used to compare survival between groups. Results The sizes and extent of the tumors were classified as I-IV according to the Masaoka clinical staging scale. Respective 5- and 10-year survival rates were： 93.8% and 79.2% in stage I, 79.3% and 55.2% in stage II, 53.1% and 34.4% in stage III, and no survivors in stage IV. Among 30 patients with associated myasthenia gravis, 19 had generalized myasthenia gravis and 11 had ocular myasthenia gravis; 5- and 10-year survival rates were 83.3% and 60.0%, respectively. The 5- and 10-year survival rates for 112 patients without myasthenia gravis were 53.6% and 42.0%, respectively. Eighty-four patients had radical resection and nine had palliative resection. Eighty-nine patients had radiotherapy and 55 patients had postoperative radiotherapy. Single or multi-variable analyses showed that the main prognostic indicators are Masaoka clinical staging, thymoma-associated myasthenia gravis, and the treatment method. Conclusions The most important indicators of long-term survival in thymoma are Masaoka clinical staging and the completeness of resection. The primary treatment method for thymoma should be wide tumor resection. Pre- and/or postoperative radio- and/or chemotherapy should be given according to individual treatment requirements.     

卵巢恶性肿瘤患者保留生育功能治疗的预后及相关因素分析

目的探讨3种不同类型卵巢恶性肿瘤患者保留生百功能治疗的颁后及其相关因素。方法回顾性分析189例保留生育功能治疗的卵巢恶性肿瘤患者的生存率、复发与未控率、生育状况等情况。189例中生殖细胞肿瘤（OGCT）136例,性索间质肿瘤（OSCST）31例,上皮性癌（EOC）22例。对OGCT、OSCST、EOC3组患者的中位随访时间分别为50、46、45个月。结果OGCT、OSCST、EOC3组患者的5年生存率分别为94．0％（131／134）、77．1％（26／30）、64．7％（16／21）,复发与未控率分别为29．9％（40／134）、20．0％（6／30）、47．6％（10／21）,随访期内共有46例次的患者分娩。规范化疗是影响OGCT生存率及复发与未控率的独立因素;对于OSCST,FIGO分期、规范化疗分别是影响生存率和复发与未控率的因素。全面分期手术及FIGO分期是影响EOC生存率和复发与未控率的因素。结论保留生育功能治疗对于OSCST和EOC需强调个体化,而对于OGCT则不受FIGO分期限制。治疗结局以OGCT最好,OSCST次之,EOC最差。     

朗格汉斯组织细胞增生症放射治疗的临床研究

目的通过对一组临床资料研究,来探索朗格汉斯组织细胞增生症(LCH)放射治疗的最佳剂量和患者的预后情况。方法回顾性研究笔者所在科室自1986～2008年收治的40例诊断为LCH伴有骨组织病变患者,Ⅰ期患者20例,有20个放疗部位;Ⅱ期患者17例,有22个放疗部位;Ⅲ期患者3例。把以上病例分为高剂量组(≥16Gy)和低剂量组(<16Gy),然后比较两组的疗效。结果Ⅰ期患者局部病灶控制率为100%,5年生存率100%。Ⅱ期的患者局部病灶控制率为86%,5年生存率87%。Ⅲ期的患者局部病灶控制率为100%(3/3),5年生存率67%(2/3)。两组的疗效没有统计学意义(P=0.390)。结论低剂量的放射治疗能够有效地控制局部病灶,而不会导致严重的并发症,三维适形放射治疗是治疗LCH局部骨病变及化疗和手术后残余病灶的一个有效的手段。     

26例原发性小肠恶性肿瘤的诊治体会

目的总结原发性小肠恶性肿瘤的临床表现及探讨其有效的诊治方法,以提高早期确诊率,从而提高疗效。方法回顾性分析26例小肠恶性肿瘤的临床表现、诊断方法、手术方式和预后情况。结果本组根治性切除术后1、3、5年生存率分别为94.4%(17/18),77.8%(14/18),38.9%(7/18),姑息性切除和短路手术术后1年生存率37.5%(3/8),生存无超过3年者。结论根治性切除与姑息性切除相比,术后1、3、5年生存率均明显升高。     

39例多原发结直肠癌的临床研究

目的分析结直肠多原发癌其临床特征及预后。方法对本院2000年1月~2007年12月收治的1462例结直肠癌病例进行
回顾性分析,根据Warran和Gates提出的多原发癌（MPC）的诊断标准,筛选出39例MPC,并对其发病年龄、5年生存率、病变部
位以及治疗方式与生存时间的关系等进行统计。结果（1）MPC的发生率为2.67%（39/1462）,同时性多原发癌（SC）18例,异时
性多原发癌（MC）21例;（2）MPCC好发于左半结肠和直肠,发病年龄为61.02±13.94岁,5年生存率为61.76%;MC的预后优于
SC;（3）3例早期MPCC,根治性手术后5年生存率100%;30例中晚期MPCC行根治性手术+辅助性化疗,1-、3-、5-年生存率分别
为93.33%、83.33%、73.33%,3 例中晚期MPCC行姑息性手术+辅助性化疗,1 年和3 年生存率分别为66.67%和0,3 例中晚期
MPCC仅行姑息性化疗,1年和3年生存率也分别为66.67%和0。结论早期诊断并有效治疗MPC,可提高患者的生存率;根治
性手术和化疗对中晚期MPCC患者的生存与预后明显有益。
     

珠海市鼻咽癌放疗后5年生存随访报告

 【目的】通过随访珠海市2003年3月－2005年3月接受根治性放疗的鼻咽癌患者,计算5年生存率和5年无局部复发率（FLF)和无远处转移生存率（FDM）,评价珠海市鼻咽癌的治疗的临床疗效。【方法】随访满5年患者154例, UICC／AJCC 2002分期Ⅰ、Ⅱ、Ⅲ和Ⅳ期分别为12、40、82和20例,随访60～84个月,接受根治性放疗后的5年随访资料纳入研究, 以生存率、无鼻咽局部复发生存率和FDM为预后指标, 通过Cox比例风险模型,分析比较影响鼻咽癌生存、局部复发和远处转移的因素。【结果】5年随访生存率：第1年98%,第3年88% ,第5年79%;5年无局部复发生存率为85.1%;5年FDM为88.31%。全组患者远期放疗不良反应均不明显。根据现有数据的Cox多因素分析提示,临床分期的早晚仍然是影响5年生存率最明显的因素。【结论】珠海市2003年3月－2005年3月收治的鼻咽同期化放疗后患者,在生存率、无局部复发生存率、FDM以及在远期副反应的控制方面,均达到先进水平。     

137例胸腺上皮肿瘤的预后影响因素

目的：通过对胸腺上皮肿瘤患者临床、病理资料进行分析,探寻与疾病预后相关的影响因素。方法：本院心胸外科1997年6月至2007年9月胸腺上皮肿瘤病例137例,记录患者临床、病理资料,并于术后进行随访,按照Masaoka病理分期将所有病例分为Masaoka I/II期和III/IV期两组,按照WHO组织学分型将所有病例分为WHO A/AB/B1组和B2/B3/C组,应用Kaplan-Meier法、COX回归模型等寻找疾病预后的相关因素。结果：所有病例中124例（90.5%）行全切手术,9例（6.6%）行姑息性切除,4例（2.9%）行活检术。Masaoka I/II期病例中手术全切率（100％）明显高于III/IV期病例的全切率（分别为67.9%和63.6%,P＜0.001）。137例病例中总的5年、10年总生存率为71.4％和50.1％。Masaoka I/II期病例生存率明显高于III期、IV期病例(P＜0.001）;按照WHO分型,A/AB/B1型5年、10年生存率明显高于B2/B3/C型病例 (P＜0.001）;完全切除病例术后5年、10年生存率明显高于不完全切除和活检病例（P＜0.001）。COX回归分析发现,Masaoka病理分期、WHO组织学分型、肿瘤完全切除及手术时年龄与预后相关。结论：Masaoka病理分期、WHO组织学分型、肿瘤完全切除及手术时患者年龄是胸腺上皮肿瘤患者重要的预后相关因素     

改良根治性/根治性子宫切除在Ⅰ期子宫内膜样腺癌局控中的治疗价值

 目的 探讨改良根治性/根治性子宫切除在降低Ⅰ期子宫内膜样腺癌局部复发中的价值。 方法 对1996年1月至2008年12月在本院行改良根治性/根治性子宫切除的Ⅰ期子宫内膜样腺癌临床病理资料进行回顾性分析,并随访患者的复发和生存情况。应用Kaplan-Meier法对所有患者的复发、生存情况进行分析。结果 518例Ⅰ期子宫内膜样腺癌中474例行改良根治性/根治性子宫切除 + 双附件切除 ± 盆腔淋巴结清扫 ± 腹主动脉旁淋巴结清扫 + 腹水/腹腔洗液细胞学检查,12例（2.5%）患者术前接受放、化疗,73例（15.4%）患者术后补充放、化疗。中位随访30个月后,16例患者最终复发转移。8例远处转移,4例阴道残端复发,4例盆腔复发。3年、5年阴道残端累积复发率为1.4%和2.0%, 局部复发（阴道 + 盆腔）比率为2.5%和3.1%,3年和5年的总生存率均为98.1%。Ⅰa、Ⅰb、Ⅰc期5年局部复发率分别为3%、3.7%和0 （P=0.649）,5年生存率分别为98.3%、97.8%和100% （P=0.399）。淋巴结清扫与否不影响局部复发率以及生存率（P值分别为0.525和0.665）。中位手术时间为135 min,中位出血量300 mL,输血比率为15.4%,术中、术后手术相关并发症为7.0%,无手术相关死亡病例。结论 改良根治性/根治性子宫切除有效地提高了Ⅰ期子宫内膜样腺癌局控率,可望作为Ⅰ期子宫内膜样腺癌另一治疗选择,急需进行随机临床研究进一步证实其在Ⅰ期子宫内膜样腺癌治疗中的价值。     

常规剂量紫杉醇联合顺铂术前同步放化疗治疗胸段食管癌的临床研究

目的 探讨常规剂量紫杉醇联合顺铂术前同步放化疗治疗胸段食管癌的疗效.方法 对26例食管癌初治患者采用术前同步放化疗,Ⅱ期17例,Ⅲ期9例,常规分割放疗2 Gy/d,每周5 d,总量40 Gy,存放疗的第1周和第4周给予化疗,紫杉醇135 mg/m2,静脉滴注3 h.第1天,顺铂20mg/m2,静脉滴注,第1～3天;放化疗结束后休息4～6周,行食管癌根治术.用Kaplan-Meier法进行生存率和无病生存率分析,Logrank检杏评估组间生存差异.结果 患者均采用左进胸,食管胃颈部吻合,根治性切除率96.15%.术后组织病理反应:Ⅰ级9例,Ⅱ级6例,Ⅲ级11例.完全病理缓解率为42.31%(11/26).放化疗导致的Ⅲ级以上毒性反应主要为白细胞下降7.69%(2/26),血小板下降7.69%(2/26),放射性食管炎11.54%(3/26).手术并发症为:吻合门瘘3.85%(1/26)、喉返神经损伤7.69%(2/26)、乳糜胸3.85%(1/26).中位随访时间42.28个月,3、5年生存率分别为62.96%、54.56%,3、5年无病生存率分别为59.94%、55.65%,术后原发灶不同病理反应的患者3年生存率分别为25.4%(Ⅰ级),60.00%(Ⅱ级),90.91%(Ⅲ级),5年生存率分别为0(Ⅰ级),60.00%(Ⅱ级),81.82%(Ⅲ级)(P<0.05).结论 常规剂量紫杉醇和顺铂术前同步放化疗可能提高诱导放化疗后病理反应达到Ⅱ级以上食管鳞癌患者的5年生存率,没有增加治疗相关并发症.     

Postoperative radiotherapy for stage I thymoma: a prospective randomized trial in 29 cases

OBJECTIVE To determine the effect of postoperative radiotherapy on stage I thymoma.

METHODS Twenty-nine patients with stage I thymoma younger than 65 years, treated between August 1981 and January 1996 were included in this study. All patients were randomly assigned into two groups: surgery alone (13 patients) and surgery with postoperative radiotherapy (16). Staging was based on the surgical and pathologic criteria that the tumor had a complete capsule and without capsular invasion microscopically. Adjuvant radiotherapy was started within 4 weeks after surgery. Megavolage radiation, using the isocentric technique, was administered through an anterior field and/or two anterior oblique wedge fields. For the patients with lymphocytic predominant type, the dose was 50 Gy in 25 daily fractions for 5 weeks; for the patients with epithelial cell type or mixed type, the dose was 60 Gy in 30 daily fractions for 6 weeks. The survival rates were estimated by the Kaplan-Meier method.

RESULTS There was no recurrence and metastasis in either group. No acute and late radiological injuries were found among the patients receiving radiotherapy postoperatively. The 5-year and 10-year survivals were both 92% for the patients treated by surgery alone. However, the survival rates for patients who received radiotherapy were both 88%. There was no difference in the survivals in these two groups. Of the 3 died patients, 1 died of myasthenia gravis and 2 of intercurrent illness. No significant correlation was found between myasthenia gravis and radiotherapy.

CONCLUSIONS Postoperative radiotherapy is unnecessary for the patients with stage I thymoma. No relation is found between radiotherapy and myasthenia gravis.

     

Management of oesophageal cancer at Westmead Hospital from 1979-1985

The aim of this study was to evaluate the various treatment options, including radiotherapy, surgery and chemotherapy, when all patients with carcinoma of the oesophagus were assessed and managed by the same team. From December 1, 1979 to December 31, 1985, 144 patients with carcinoma of the oesophagus were referred to Westmead Hospital. Eighty-five patients were men, 59 patients were women and the median age was 63 years. Twenty-five patients were at stage I, 75 patients were at stage II, 24 patients were at stage III and 20 patients were at stage IV of oesophageal cancer. Forty-two patients underwent surgical resection. Fifty patients underwent radical radiotherapy, 30 patients underwent palliative radiotherapy and 22 patients underwent palliative intubation. The operative mortality of those patients who underwent surgery was zero. The treatment mortality of those who underwent radical radiotherapy was 6%, and for those who underwent palliative radiotherapy, was 16.7%. The mortality after intubation was 12.5%. The prevalence of benign strictures was 7.5% after surgery, 33% after radical radiotherapy and 8% after palliative radiotherapy. The prevalence of malignant strictures (recurrent disease) was 2.5% after surgery, 21% after radical radiotherapy and 20% after palliative radiotherapy. The median survival after surgery was 12 months; that after radical radiotherapy, 12 months; that after palliative radiotherapy, six months; and that after intubation, 3.5 months. Where all patients with carcinoma of the oesophagus were managed by a team approach the treatment mortality was low but the long-term survival remained poor.     

肝肉瘤16例临床诊治分析

目的 探讨肝脏原发肉瘤的诊断、治疗方法以及预后因素.方法 对1980年至2005年期间收治并经病理证实的16例肝肉瘤的临床资料进行回顾性分析.结果 16例患者临床症状以右上腹不适(56.3%)和右上腹包块(56.3%)多见.AFP均为阴性.术前影像学检查无一例做出准确诊断.15例患者接受手术,其中R0切除7例(46.7%),姑息性切除及切取活检8例.1例未行手术,仅行介入治疗.病理诊断为肝平滑肌肉瘤6例(37.5%),肝血管肉瘤5例(31.25%),纤维肉瘤2例(12.5%),上皮样血管内皮瘤1例(6.25%),黏液脂肪肉瘤1例(6.25%),未分化肉瘤1例(6.25%).总体1,3,5年生存率分别为71.4%,41.7%,33.3%.R0切除的患者1,3,5年生存率分别为100.0%,83.3%,66.7%,明显优于非R0切除组(P=0.011).单发肿瘤直径≤5 cm的病例1,3,5年生存率分别为100%,100%,75%,优于直径＞5 cm组,但差异无统计学意义(P=0.084).结论 肝肉瘤的诊断较为困难,手术切除目前是其主要治疗方式.是否获得R0切除以及肿瘤大小是预后的重要因素.     

晚期前列腺癌膀胱出口梗阻患者姑息性经尿道前列腺切除术疗效评价

目的：评估晚期前列腺癌合并严重膀胱出口梗阻患者实施姑息性经尿道前列腺切除术（palliative transurethral resection of the prostate,pTURP）的治疗效果及预后。方法：回顾性分析北京大学第三医院泌尿外科2007年11月至2015年1月所有实施pTURP的16例晚期前列腺癌膀胱出口梗阻患者,这16例患者的肿瘤分期为Ⅲ期或Ⅳ期,均伴严重膀胱出口梗阻症状（内分泌治疗后仍有尿潴留、大量残余尿及合并上尿路积水）。收集患者临床资料、围手术期以及术后随访情况,并通过Kaplan-Meier分析计算病例的肿瘤特异生存率。结果：患者平均年龄73.8岁（63~81岁）,其中前列腺癌Ⅲ期5例、Ⅳ期11例;手术指征为12例反复发生尿潴留,4例大量残余尿伴尿路积水;手术前平均前列腺体积43.2 mL（28~78 mL）,术前平均前列腺特异性抗原（prostatespecific antigen,PSA）48.2 μg/L（ng/mL,2~107 μg/L）,残余尿量166.4 mL（50~450 mL）,术前平均尿流率为3.6 mL/s（0~6 mL/s, n=7）。手术时间62.9 min（35~94 min）,出血量126.9 mL（30~263 mL）,手术切除组织14.1 g （10~22 g）,无输血病例。术后PSA平均20.5 μg/L（1~41 μg/L）,残余尿量平均43.4 mL（0~ 400 mL）,平均尿流率为10.1 mL/s（7~16 mL/s, n=7）;1例出现术后持续血尿,保守治疗后好转;术后6例患者延迟排尿,1例需长期留置膀胱造瘘管;2例患者进行二次手术切除。与术前相比,患者pTURP术后血清PSA下降（P＜0.001）,残余尿量减少（P＜0.001）,平均尿流率增加（P= 0.001）。平均随访时间36个月（1~86个月）, 3例患者死于前列腺癌的进展,患者pTURP术后2年、3年及5年肿瘤特异生存率分别为91%、78%、58%。结论：pTURP对缓解晚期前列腺癌患者膀胱出口梗阻有效,但组织切除量少、术后延迟排尿及二次手术率高,虽然不能完全排除手术对生存率的不良影响,但术后相对较高的肿瘤特异性生存率提示pTURP是一个可以选择的术式。     

早期鼻咽癌调强适形放射治疗的长期疗效及不良反应

 目的 观察调强适形放射治疗（intensity-modulated radiation therapy,IMRT）治疗Ⅰ、Ⅱ期鼻咽癌（nasopharyngeal carcinoma,NPC）患者的长期随访结果、分析预后相关影响因素及不良反应。方法 回顾性分析2005年6月至2015年12月接受IMRT治疗的210例T1-2N0-1期NPC患者,其中Ⅰ期35例（16.7%）、Ⅱ期175例（83.3%）。Ⅱ期中113例（64.6%）接受了放化疗,余行单纯放疗。鼻咽和区域淋巴结肿瘤靶区剂量为66 Gy/30次。结果 中位随访时间91个月,5年、10年生存率分别是97.1%、87.8%。5年、10年局部控制率、区域淋巴结控制率和无远处转移率分别是95.7%、92.8%,98.6%、98.6%和96.2%、94.1%。Ⅱ期113例化疗组和未化疗组的5年、10年生存率、区域淋巴结控制率、无远处转移率差异均无统计学意义（P=0.535,0.942,0.754）。放化疗组的局部控制率比单纯放疗组高（P=0.009）。无4度晚期反应,3度晚期反应发生率低,主要是听力下降、龋齿、口干,放射性颅神经损伤和颞叶损伤的发生率为1.4%和3.3%。第2肿瘤发生率为6.7%。结论 接受IMRT治疗的Ⅰ、Ⅱ期NPC患者在局部、区域控制率、无远处转移率和生存率方面均有明显获益,不良反应低。Ⅱ期患者加用化疗未提高生存率。     

The therapeutic and biological effects of total lymph node irradiation and autologous bone marrow infusion on malignant lymphoma patients.

Forty patients with malignant lymphoma were treated by 60Co total lymphoid irradiation (TLI): 21 cases received 6 Gy and 19 received 8 Gy. Ten also received autologous bone marrow infusion (ABMI). Acute radiation damage with digestive tract reaction and hemopoietic and immunological depression was observed. Bone marrow was depressed. WBC and platelets decreased rapidly. Lymphocytes showed quantitative and qualitative changes even at the early stage. All these symptoms subsided within 40 days. TLI accompanied by irradiation of the tumor site could result in effective control. The 1-, 3-, and 5-year survival rates of malignant lymphoma patients were 30/40 (75%), 14/24 (58%) and 4/12 (33%), respectively, while in those with Hodgkin's disease alone, the 1- and 3-year survival rates were 10/13 (76%) and 5/7 (71.4%), respectively. ABMI hastened hemopoietic reconstitution, which recovered relatively quickly after TLI.