三维立体适形放疗治疗恶性肿瘤的临床应用(附830例报告)

目的 探讨三维立体适形放疗(3D-CRT)治疗恶性肿瘤的临床应用价值.方法 1999年7月～2006年10月采用德国Leibinger三维立体适形放射治疗设备、美国Varian 600C/D 6MeV X线直线加速器 多叶光栅对830例恶性肿瘤病人进行非共面多野三维立体适形放疗,单次剂量4～8Gy,隔日1次,总照射剂量50～82Gy.对治疗结果进行回顾性分析.结果 CT显示完全缓解(CR)率20.7%(172/830),部分缓解(PR)率68.7%(570/830),无变化(NC)率10.2%(85/830),进展(PD)率0.3%(3/830),总有效率(CR PR)89.4%(742/830),无严重并发症.结论 对于有内科禁忌证或由于其他情况不能手术的恶性肿瘤病人,3D-CRT是一种比较有效的治疗手段,可以提高肿瘤的治疗剂量,降低周围正常组织的损伤,有助于提高生存率,改善生存质量,减少并发症.

Clinical application of three-dimensional conformal radiotherapy (3D-CRT) for malignant tumors: a report of 830 cases

Objective To evaluate the therapeutic effects of three-dimensional conformal radiotherapy(3D-CRT) for malignant tumors.Methods From July 1999 to October 2006,830 patients with malignant tumors received non-coplanarity multifield 3D-CRT by using Leibinger three-dimensional stereotactic conformal radiotherapy machine,Varian 600C/D 6MeV X liner accelerator and multileaf collimator.Single dose was 4-8Gy per fraction,once every two days and total dose was 50-82Gy.Results All 830 cases underwent 3D-CRT.According to the WHO evaluation standard for therapeutic effects,CT results showed that complete response(CR),partial response(PR),no change(NC),and progression(PD) rates were 20.7%(172/830),68.7%(570/830),10.2%(85/830),and 0.3%(3/830),respectively.Overall response rate(CR+PR) was 89.4%(742/830).No patients suffered from serious adverse effects.The incidence of radiation penumonia was 9%.Conclusions For patients with malignant tumors who could not endure operations due to existing contraindications or other conditions,3D-RCT was a relatively effective treatment because the method could deliver an increased therapeutic dose to tumors,enhance survival rate,improve life quality,decrease injuries to adjacent normal tissue,and reduce the incidence of complications.