三维立体适形放疗治疗恶性肿瘤的临床应用(附830例报告)  

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

作　　者：侯友贤[1] 石卫民[1] 李工[1] 李志强[1] 贾峻嵩[1] 陈海[1] 

机构地区：[1]广州军区广州总医院放射肿瘤中心,广州510010

出　　处：《解放军医学杂志》2007年第7期664-666,共3页Medical Journal of Chinese People's Liberation Army

基　　金：广东省医学科研基金立项课题(A2002535)

摘　　要：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Varian600C/D6MeVX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。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 contraindi- cations or other conditions, 3D-RCT was a relatively effective treatment because the method could deliver an increased therapeutic dose to tufters, enhance survival rate, improve life quality, decrease injuries to adjacent normal tissue, and reduce the incidence of complications.

关 键 词：肿瘤治疗方案 放射疗法 适形 

分 类 号：R730.55[医药卫生—肿瘤]