后程立体定向放射治疗腹膜后淋巴结转移癌的疗效观察

目的　探讨后程立体定向放射治疗腹膜后淋巴结转移癌的疗效。方法　选择 2 9例消化道恶性肿瘤所致腹膜后淋巴结转移癌病人 ,包括食管中、下段鳞癌放疗后转移的 13例 ,胃腺癌术后转移的 6例 ,胃未分化癌术后转移的 4例 ,结肠低分化腺癌术后转移的 6例。先给予常规外照射DT 3 5～ 5 0Gy ,4～ 5周 ,休息 7天后行后程立体定向放射治疗补量治疗 ,分次治疗方法为DT 5～ 8Gy/次 ,隔日 1次 ,4～ 8次为 1个疗程 ,平均补量为DT 3 5Gy( 2 5～ 45Gy)。结果　治疗后 3～ 6个月 ,CT及MRI复查示 :CR 3 4 5 %、PR5 1 7%,总有效率为 86 2 %。所有病例KPS评分均提高 ,未出现明显放疗并发症。结论　后程立体定向放射治疗补量治疗消化道肿瘤所致腹膜后淋巴结转移癌疗效肯定 ,可作为临床上首选的—种治疗方法

Clinical Observasion of Late Course Sterotactic Radiotherapy for 29 Patients with Retroperitoneal Lymph Node Metastases

Objective To explore the clinic effects of the late course stereotactic radiotherapy in the treatment of retroperitoneal lymph node metastases Methods 29 enteron malignant tumor patients with retroperitoneal lymph node metastases were studied,including 6 gastric adenocarcinoma patients,4 gastric undifferentiated carcinoma patients and 6 poorly differentiated colon adenocarcinoma patients All of them were after surgery Also including 13 patients with mid or lower thoracic segments of esophageal carcinoma after radiotherapy All patients were undertaken late course stereotactic radiotherapy after the routine radiotherapy The stereotactic mean dose was 35 Gy Result After the stereotactic radiotherapy 3-6 months, the retroperitoneal lymph node metastases were reexamined with CT and MRI It showed that CR 34 5%,PR 51 7%, the effective rate was 86 2% KPS was improved in all patients and had no radiation complications Conclusions The stereotactic radiotherapy for retroperitoneal lymph node metastases was effective It could increase the response rate effectively and improve the life quality for retroperitoneal lymph node metastases