进展期胃癌术后调强放疗联合同期化疗的初步结果  

Preliminary result of intensity-modulated radiotherapy combined with concurrent chemotherapy for postoperative advanced gastric carcinoma

作　　者：韩志义[1] 路树强[1] 杨致富[1] 王文璋 文雨明 王幼黎[1] 耿凤勇[1] 高举[1] 蔡爱兵[1] 

机构地区：[1]北京航空中心医院,北京100012

出　　处：《中国现代医学杂志》2010年第8期1222-1224,共3页China Journal of Modern Medicine

摘　　要：目的观察进展期胃癌术后调强放疗联合同期化疗的临床效果。方法进展期胃癌根治术后患者180例,随机分为对照组和观察组各90例,对照组接受FOLFOX4方案,全部患者接受2～3周期化疗;观察组在对照组的基础上实施调强放疗,PTV边缘的处方剂量为50 Gy。结果观察组完全缓解4例,部分缓解46例,无变化37例,进展3例,完全缓解+部分缓解占55.6%;对照组分别为2、36、44和8例,完全缓解+部分缓解占40.0%。观察组近期疗效优于对照组(P<0.05)。观察组白细胞分级:Ⅰ级34例、Ⅱ级12例、Ⅲ级7例和Ⅳ级1例;对照组分别为32例、13例、6例和2例。两组比较无显著性差异(χ2=0.67,P>0.05)。观察组发生急性放射反应4例,能够耐受。结论进展期胃癌术后实施调强放疗联合同期化疗与常规化疗相比,提高近期疗效完全缓解+部分缓解率,急性毒副反应可以耐受,可以推荐临床应用。【Objective】To observe clinical effects of intensity-modulated radiotherapy（IMRT） with concurrent chemotherapy on advanced gastric carcinoma after surgery.【Methods】A total of 180 patients after radical resection of advanced gastric carcinoma were randomly divided into 2 groups（90 in each group）.All the patients in the control group received FOLFOX4 regimen with 2-3 cycles of chemotherapy,while those in the study group had addi-tional IMRT with the given prescription dose of 50 Gy at the margin of the planning target volume（PTV）.【Results】 In the study group,4 cases achieved complete remission（CR）,46 cases achieved partial remission（PR）,37 had no change（NC） and 3 had progression（PD）;the response rate was 55.6%.In the control group,2 cases achieved CR,36 PR,44 NC and 8 PD;the response rate was 40.0%.The short-term effectiveness of the treatment strategy in the study group was significantly better than that in the control group（P 0.05）.In the study group,white cell count decreased to grade Ⅰin 34 cases,to grade Ⅱ in 12,to grade Ⅲ in 7 and to grade Ⅳ in 1;while in the control group,the white cell count dropped to grade Ⅰin 32 cases,to grade Ⅱ in 13,to grade Ⅲ in 6 and to grade Ⅳ in 2.There was no significant difference in the decrease of white cell count between both groups（χ2=0.67,P 0.05）.Four patients in the study group had acute radiation reaction which was tolerable.【Conclusion】For postoperative advanced gastric carcinoma,intensity-modulated radiotherapy combined with chemotherapy has the advantages of elevation of the response rate and acceptable acute adverse reaction over conventional chemotherapy.It can be recommended for clinical use.

关 键 词：进展期胃癌 手术 调强放疗 化疗 

分 类 号：R735.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]