甲状腺癌100例术后放射治疗  

Postoperative radiotherapy of 100 cases of thyroid carcinoma

作　　者：叶乃瑶[1] 贺盛光[1] 钟知强[1] 

机构地区：[1]四川省人民医院,610072

出　　处：《四川医学》2000年第3期197-199,共3页Sichuan Medical Journal

摘　　要：目的　分析甲状腺癌术后放射治疗疗效。方法　 1978年 6月至 1986年 6月收治的甲状腺术后患者 10 0例 ,年龄 7～ 65岁 ,平均年龄 3 5岁。术后估计切除干净行预防性放疗 2 8例 ,术后残余癌行放疗 72例。所有病例均有术后病理诊断。全组均采用60 Co -γ线外照射 ,部分患者加用深度X线照射 ;术后行预防性放疗者 ,照射野包括原病变局部和瘤床区。对分化程度低 ,有淋巴结转移者 ,设野靶区自扩大包括双颈 ,病变达胸骨后上份者包括上纵隔。每天照射肿瘤量 1 8～ 2Gy ,每周照射 5次。本组实照肿瘤量为 3 4 8～ 65 2 5Gy/3 5～ 6 5周。对残余癌者放疗剂量高。 结果　本组随访率为 97% ,生存期从放疗日起计算 ,5 ,10 ,15年生存率分别为 90 % ( 90 /10 0 ) ,67% ( 67/10 0 )和 5 0 % ( 3 0 /60 )。结论　甲状腺癌首选手术治疗。术后残余癌加用放疗可提高疗效 ,甲状腺癌有淋巴结转移者长期生存差。甲状腺癌术后放疗肿瘤量以 40～ 60Gy/4～ 6周为宜。照射剂量应根据病理类型、病变范围、淋巴结转移情况及年龄等因素综合考虑。Objective [WT5”BZ]To evaluate the efficacy of postoperative radiotherapy for thyroid carcinoma.[WT5”HZ]Methods [WT5”BZ]100 patients with thyriod carcinoma were treated by postoperative radiotherapy in our department from June,1978 to June,1986.The ages ranged 7 to 65 years with the mean 35 years.28 cases were treated by preventive postoperative radiotherapy.72 postoperative cases with residual carcinoma were treated by rediotherapy.All the cases were confirmed by postoperative histo pathology.All the patients were irradiated with 60 Co γ ray.Some of the patients were irradiated with deep X ray after the 60 Co γ ray irradiation.To the cases with better differentiation and treated by preventive postoperative radiotherapy,the fields included the primary focuses and tumor beds.To the cases with poor differentiation and lymphatic metastasis,the target fields included the neck.To the cases with focuses in the upper posterior sternum,the fields included the upper mediastinum.The tumor dose was 1.8～2Gy per day,5 times/WK.The actual tumor dose was 34.8～65.25Gy/3.5～6.5wks.The patients with residual carcinoma were given high doses.[WT5”HZ]Results [WT5”BZ]The follow up rate of the group was 97%.The survival time was calculated from the beginning of radiotherapy.The 5 ,10 ,and 15 year survival rates were 90%(90/100),67%(67/100)and 50%(30/60),respectively.[WT5”HZ]Conclusion [WT5”BZ]Operation is the first choice for thyroid carcinoma.Radiotherapy can improve the therapeutic effect on postoperative residual carcinoma.The long term survival of the patients with thyroid carcinoma and lymphatic metastasis is unusual.The available tumor dose of postoperative radiotherapy for thyroid carcinoma is 40～60Gy/3～6wks.The irradiation dose should be considered comprehensively

关 键 词：甲状腺癌 术后 放射疗法 

分 类 号：R736.1[医药卫生—肿瘤]