立体定向放疗或三维适形放疗治疗膀胱癌疗效与并发症分析比较  

Comparison of Curative Effect and Complication of Bladder Carcinoma with Stereotactic Radiotherapy or 3- D Conformal Radiotherapy

作　　者：刘仙明[1] 郭建平[1] 王晓燕[1] 周尔玺 

机构地区：[1]淄博市妇幼保健院肿瘤科,山东淄博255029

出　　处：《泌尿外科杂志（电子版）》2015年第3期50-54,共5页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的分析比较采用立体定向放疗或三维适形放疗治疗膀胱癌的疗效与并发症。方法近7年43例膀胱癌患者在本科室行立体定向放疗或三维适形放疗,其中26人采用立体定向放疗,每次280 c Gy,每周5次,共13~15次,PTV周边总剂量3650~4200 c Gy。17人采用三维适形放疗,每次200c Gy,每周5次,共25~30次,PTV周边总剂量5000~6000 c Gy,所有患者治疗结束后3个月行膀胱镜和CT检查评价短期疗效,随访3~36个月,以观察远期治疗效果及不良反应发生情况。结果所有病人血尿症状减轻或消失,立体定向放疗组,CR5例,PR11例。三维适形放疗组,CR2例,PR7例。2组的短期疗效有差异(P=0.022),放疗后膀胱内复发27例,均再次行立体定向放疗或三维适形放疗。2组中位生存时间分别为18.00个月和16.00个月。立体定向放疗组晚期泌尿系统反应高于三维适形放疗组(P=0.033),三维适形放疗组急性消化系统反应高于立体定向放疗组(P=0.024)。结论膀胱癌采用立体定向放疗可以获得较三维适形放疗更好的局部控制率,延长FPS,采用立体定向放疗晚期泌尿系统反应较重,但急性消化系统反应较轻。Objective To analyze the curative effect and complication of bladder carcinoma with stereotactic radiotherapy or 3-D conformal radiotherapy. Methods 43 cases of bladder cancer patients in our department was treated with stereotactic radiotherapy or 3 -D conformal radiotherapy in recent 7 years. 26 patients were treated with stereotactic radiotherapy,280 cGy per time,5 times a week,13 -15 times,The peripheral total dose of PTV was 3650 -4200 cGy. 17 patients were treated with 3 -D conformal radiotherapy,200 cGy per time,5 times a week,25-30 times,The peripheral total dose of PTV was 5000-6000 cGy. The short-term efficacy of all patients was evaluated with bladder endoscopy and CT at 3 months after the treatment,All patients were followed up for 3-36 months to observe the long-term therapeutic effect and the adverse reactions. Re-sults The symptoms of hematuria were relieved or disappeared in all patients. Stereotactic radiotherapy group, CR 5 cases,PR 11 cases. 3-D conformal radiotherapy group,CR 2 cases,PR 7 case. There was significant difference in short-term efficacy between the 2 groups (P=0 . 022 ),. 27 patients were recurrence in bladder after radiotherapy,and were performed with stereotactic radiotherapy or 3-D conformal radiotherapy again. The median survival time in the 2 groups was 18 months and 16 months respectively. The late urinary system re-sponse in the stereotactic radiotherapy group was higher than that in the 3-D conformal radiotherapy group (P=0 . 033 ),and the acute digestive system response in the 3-D conformal radiotherapy group was higher than that in the stereotactic radiotherapy group (P =0 . 024 ). Conclusions Treatment of bladder cancer with ster-eotactic radiotherapy can be obtained better local control rate than with 3-D conformal radiotherapy and prolong the FPS,stereotactic radiotherapy in treatment can cause worse advanced urinary system response,but the acute digestive system reaction is lighter.

关 键 词：立体定位技术 三维适形 膀胱肿瘤 

分 类 号：R737.14[医药卫生—肿瘤]