肺癌合并上腔静脉综合征患者立体定向放射治疗的临床疗效分析  

Clinical effect of stereotactic radiotherapy for lung cancer with superior vena cava syndrome

作　　者：吴彩珍[1] 黄润生[1] 钱伟[1] 毛树权[1] 房景玉[1] 王佳薇[1] 

机构地区：[1]解放军第117医院伽马刀治疗研究中心,杭州310013

出　　处：《解放军医学杂志》2006年第7期722-723,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的 评价立体定向放射治疗肺癌合并上腔静脉综合征（SVCS）的临床疗效。方法采用OUR-QGD型立体定向伽马射线体部治疗系统（体部伽马刀）治疗31例SVCS患者，就诊时病理诊断明确者17例，其中鳞癌7例，腺癌4例，小细胞未分化癌5例，鳞腺癌1例，另14例经胸部CT／MRI影像学检查及临床诊断为右肺癌，未做病理检查。临床表现为颜面及颈胸部浮肿31例，胸闷、气急30例，呼吸困难23例，前胸壁静脉曲张1例。治疗后对患者进行随访，除2例失随访外，其余29例患者均随访至死亡，随访时间为2-20个月，并对治疗结果进行分析。结果 治疗结束时31例患者临床症状、体征均显著改善。获随访的29例患者在治疗后1-6个月后复查CT，达完全缓解（CR）8例，部分缓解（PR）21例，总有效率（CR＋PR）为100％，治疗后中位缓解时间为8．3个月。影像学变化：肿块消失（CR）8例，肿块缩小（PR）21例，总有效率（CR＋PR）为100％。治疗后生存时间最长者为19个月。结论 立体定向放射治疗SVCS疗效满意，治疗时间短，缓解时间长，复发率低，是一种安全有效的治疗方法。Objective To evaluate the clinical effect of stereotactic radiotherapy in the treatment of lung cancer with superior vena cava syndrome （SVCS）. Methods 31 cases of lung cancer with SVCS were treated with body gamma knife. Among them, the diagnosis was confirmed by pathological diagnosis in 17 patients, and right lung cancer was diagnosed by CT-scan and clinical examinations without path- ological diagnosis in 14 patients. Clinical manifestations included edema of the face, neck and chest （31 cases）, chest pain and difficulty in respiration （30 cases）, dyspnea （23 cases）, and varicosity over the chest wall （1 case）. 29 patients were followed-up till death after treatment, with the follow-up time ranging from 2 to 20 months, and both clinical signs and radiological changes before and after the treatment were compared. Results Clinical symptoms and signs of these 31 patients were significantly improved after the treatment. The overall ef- fective rate was 100% （CR 8 and PR 21） and the median remission time was 8. 3 months. The longest survival time reached 19 months after the therapy. Conclusion Stereotactic radiotherapy seems to be a safe and effective treatment for patients with SVCS with a satisfactory response rate, short treatment period and long remission time.

关 键 词：肺肿瘤 上腔静脉综合征 立体定向体部伽马刀 放射疗法 计算机辅助 

分 类 号：R734.2[医药卫生—肿瘤]