胸腺瘤术后放射治疗的临床意义  

Significance of postoperative radiotherapy for thymoma:analysis of 106 patients

作　　者：胡玉林[1] 张大昕[1] 贺晓慧[1] 崔守仁[1] 王瑞芝[1] 高永君[1] 

机构地区：[1]哈尔滨医科大学附属第三医院放射治疗科

出　　处：《中华放射肿瘤学杂志》2003年第4期231-233,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　探讨胸腺瘤术后放射治疗的临床价值。方法　对 10 6例接受手术或术后放射治疗的胸腺瘤患者做回顾性分析 ,按Masaoka临床分期 ,Ⅰ期 32例 ,Ⅱ期 30例 ,Ⅲ期 36例 ,Ⅳ期 8例。完全切除 6 6例 ,次全切除 2 8例 ,不能切除而行活检探查 12例。其中Ⅰ期完全切除 12例 ,Ⅱ期完全切除 14例 ,Ⅲ期完全切除 2例、次全切除 2 6例、探查活检 4例和Ⅳ期探查活检 8例 ;共 6 6例术后行放射治疗。结果　全组总 5年生存率为 73.6 % ,完全切除 6 6例和次全切除 2 8例的 5年生存率分别为89 .4 %和 5 3.6 % (P =0 .0 2 5 ) ,Ⅰ期单纯手术 2 0例和术后放射治疗 12例的 5年生存率分别为 95 .0 %和 91.2 % (P =0 .876 )。Ⅱ、Ⅲ期术后放射治疗的 5年生存率分别为 87.6 %、6 8.8% ,与单纯手术的5 0 .0 %和 2 5 .0 %比较差异有显著性意义 (P值分别为 0 .0 4 2、0 .0 35 )。结论　术后放射治疗可以提高Ⅱ、Ⅲ期患者生存率 ,胸腺瘤Ⅰ期术后行常规放射治疗无临床意义。Objective To evaluate the clinical value of postoperative radiotherapy for thymoma. Methods 106 patients with thymoma were treated by surgery or surgery plus postoperative radiotherapy.According to Masaoka staging system, 32 patients had stage Ⅰ, 30 stage Ⅱ,36 Stage Ⅲ and 8 stage Ⅳ lesions. Of all patients,66 underwent total thymectomy, 28 partial thymectomy, 12 exploration and biopsy only. Altogether 66 patients received postoperative radiation. Results The overall 5-year survival rate was 73.6%. In stage I patients, the 5-year survival rates were 95.0% for surgery alone and 91.2% for postoperative radiotherapy (P=0.876). In stage Ⅱ and Ⅲ patients , the 5-year survival rates were 87.6% and 68.8% for postoperative radiotherapy in constrast to 50.0% and 25.0% for surgery alone(P=0.042 and P=0.035) . On the other hand,the 5-year survival rates were 89.4% for radical resection and 53.6% for palliative resection with difference statistically significant(P=0.025) . Conclusion Postoperative radiotherapy is effective to improve the disease-specific survival rate in the stage Ⅱ, Ⅲ thymoma, but it is uncertain for the stage Ⅰ disease.

关 键 词：胸腺瘤 术后 放射治疗 预后 

分 类 号：R736.3[医药卫生—肿瘤]