重离子束治疗皮肤恶性肿瘤的初步临床结果  

Clinical trial of carbon ion radiotherapy for malignant neoplasm of skin

作　　者：蔡宏懿[1] 王小虎[2] 高力英[2] 张红[3] 冉俊涛[2] 张秋宁[2] 李强[3] 

机构地区：[1]甘肃省人民医院放疗科,甘肃兰州730000 [2]甘肃省肿瘤医院放疗科,甘肃兰州730050 [3]中国科学院近代物理研究所,甘肃兰州730000

出　　处：《中华肿瘤防治杂志》2010年第14期1041-1044,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(30770639);甘肃省自然科学基金(3ZS061-A25-096)

摘　　要：目的:评价重离子束对皮肤恶性肿瘤放射治疗的近期疗效和毒副反应。方法:29例皮肤恶性肿瘤患者分6批接受重离子束放射治疗,其中恶性黑色素瘤13例,皮肤鳞癌及Bowen’s病各6例,基底细胞癌2例,其他皮肤恶性肿瘤2例。照射总剂量(50～70)GyE/(6～12)d,单次剂量5.5～11.67GyE,1f/d,连续治疗。采用RTOG标准和WHO近期疗效标准分别评价毒副反应和近期疗效。结果:截止2009-05,中位随访时间为13.5个月(1～25个月),随访率为100%。29例患者中完全缓解(CR)24例(82.8%),部分缓解(PR)5例(17.2%),有效率(RR)为100%,中位生存时间为22.8个月(95%CI:20.6～24.9)。皮肤反应0度11例(37.9%),Ⅰ度9例(31.0%),Ⅱ度6例(20.7%),Ⅲ度2例(6.9%),Ⅳ度1例(3.4%);血液毒副反应治疗前后无明显改变。结论:重离子束(12C6+)放射治疗皮肤恶性肿瘤近期疗效好,并发症轻,远期疗效、晚期副反应等尚需进一步长期全面的观察和更多的研究提供依据。OBJECTIVE：To evaluate the toxicity and efficacy of carbon ion radiotherapy for malignant neoplasm of skin.METHODS：Twenty-nine patients with superficial carcinoma,which including mucosal malignant melanoma（n=13）,squamous-celled carcinoma（n=6）,Bowen’s disease（n=6）,basal cell carcinoma（n=2）,vulvar cancer（n=1） and mebiomian adenocarcinoma（n=1）.The range of total dose was 50 to 70 GyE,6～12 fractions within 6～12 days.The single dose was 5.5-11.67 GyE,1 f/d.The toxicity on organs such as the skin and blood was assessed according to the Radiation Therapy Oncology Group （RTOG）,and the efficacy was evaluated with WHO criteria.RESULTS：The median follow-up period was 13.5 months （range,1-25 months） and the follow-up rate was 100%.Of the 29 patients,24 （82.8%） achieved complete remission （CR）,5 （17.2%） achieved partial remission （PR）;The overall response rate （RR） was 100%,and the median survival time was 22.8 mouths （95%CI：20.6～24.9）.The skin reaction occurred grade 0,1,2,3 and 4 was 11 （37.9%）,9 （31.0%）,6 （20.7%）,2 （6.9%） and 1（3.4%）,respectively.The changes of blood had not a significant difference before and after radiotherapy.CONCLSIONS：Carbon ion radiotherapy is a safe and effective treatment for malignant neoplasm of skin in terms of high local control and acceptable toxicities.Additional clinical studies using a larger subject group are required to confirm the therapeutic efficacy.

关 键 词：重离子束/治疗应用 皮肤肿瘤/放射治疗 治疗效果 

分 类 号：R739.5[医药卫生—肿瘤]