38例局部中晚期胃癌三维适形放疗临床观察

目的:探讨三维适形放疗对局部中晚期胃癌的疗效。方法:经病理学证实的局部中晚期胃癌患者38例,采用前程常规放疗加后程三维适形放疗,常规放疗采用6 MV直线加速器前后平行对穿野,DT40 Gy,常规分割每次2 Gy每周5次,4 w完成。后程采用3D-CRT,三维适形治疗计划系统(3D-TPS)和电动多叶光栅,设置4～7个共面或非共面适形固定野照射,DT20 Gy,10分次,2 w完成。治疗总剂量DT60 Gy,分30次,6 w完成。结果:38例病人均按计划完成放射治疗,其中CR 10例(26.3%),PR 15例(39.5%),NC 13例(34.2%)。1、2年局部控制率和生存率分别为70.1%、61.3%和65.4%、41.6%。结论:局部中晚期胃癌采用三维适形放疗的症状改善明显,生存率和局部控制率理想,周围正常组织的损伤较轻。

Clinical observation of three dimensional conformal radiation therapy for 38 cases of locally advanced carcinoma of stomach

Objective:To approach the efficacy of three dimensional conformal radiation therapy for locally advanced carcinoma of stomach.Methods:38 cases with locally advanced carcinoma of stomach through pathobiology confirm,apply prospect conventional radiotheraphy and post-stage three dimensional conformal radiation therapy,conventional radiotheraphy applied the treatment of 6 MV accelerator linear radiotherapy,AP:PA parallel opposed portal,DT40 Gy,convention diremption every time 2 Gy 5 times per week,4 weeks to complete.post-stage three dimensional conformal radiation therapy treatment planning system and Electric Multi-Leaf Collimator,installation 4~7 pieces coplanar or in-coplanar conformal radiation therapy,DT20 Gy,10 times,2 weeks to complete.Accumulated dose of therapy was DT60 Gy,30 times,6weeks to complete.Results:Radiotherapy was completed on 38 patients successfully,the overall response rate was 66.8%(CR 26.3%,PR 39.5%),otherwise,there were 13 cases have no change(NC 34.2%),the 1,2years local control rates and survival rates were 70.1%,61.3%和65.4%,41.6%. Conclusion:Three dimensional conformal radiation therapy improving survival benefits for the patients with locally advanced carcinoma of stomach,injury obviously abatement for circa-normal tissue.