手术置管近距离和外照射结合治疗癌性肿块

目的 探讨晚期癌性肿块的治疗方法.方法 对9例无法手术切除的晚期癌性肿块进行了手术置管后,lr192近距离放射治疗结合高能X线照射.腹腔内肿块照射总剂量(DT)为 30～32 Gy/8次,共4天,外照射DT为46～50 Gy/23～25次,共5周;其他部位肿块内照射DT 15～20Gy/4～5次,共2～4天,外照射 DT 60Gy/30次,共6周.结果 9例全部有效,其中完全缓解(CR)4例(44.4%),部分缓解(PR)5例(55.56%).临床症状完全消失者6例(66.67%),大部分缓解者3例(33.33%).缓解期最少在6个月以上,局部复发或转移后通过化疗仍可达PR.放疗副作用经内科治疗后,均能使患者耐受整个放疗过程.结论 本治疗方法有助于延长晚期癌症患者的生命,并较好地改善其生活质量.

THE COMBINATION OF EXTERNAL BEAM-RADIOTHERAPY AND INTRA-OPERATIVE INTERSTITIAL AFTERLOADING BRACHYTHERAPY FOR THE TREATMENT OF MALIGNANT TUMORS

PURPOSETo evaluate treatment methods of advanced malignant tumor. METHODS From January to June 1996, 9 patients with inoperable cancer were treated by the combination of external beam radiotherapy (EBRT) and Ir-192 after loading brachytherapy into tubes implanted during the operation. The dose administered was DT30-32 Gy/8F/4d (brachytherapy) 46-50 Gy/23-25F/5wk (EBRT)for the tumor in the abdomen, while 15-20 Gy/ 4-5F/2-4d (brachytherapy) 60 Gy/30F/6wk (EBRT) for the other regions. RESULTS The combined treatment was effective in all the 9 cases, among which 4 cases had complete control (CR 44. 4%) and 5 cases had decrease in tumor size (PR 55.6%). 6 cases of them were completely free of clinical symptoms. The mininum remission period is 6 months. Local recurrence and metastasis could reachieve partial remission by chemiotherapy. The side-effects of radiotherapy could be controlled by medical treatment so that the patients could tolerate the whole course. CONCLUSION With this modality, it is possible to prolong the life of the patient with advanced malignant tumor, and a better quality of life is achieved.