摘要
目的 比较基于数控多叶准直装置（MLC）三维适形放射治疗计划系统（3D-CRT）与立体定向放射治疗（sRT）系统圆形准直器治疗肿瘤的临床疗效。方法 81例体部肿瘤患者，分为3D-CRT治疗组41例和SRT对照组40例。3D-CRT组病灶45个，设计照射等中心45个；SRT组病灶54个，照射等中心78个。靶区勾画大体肿瘤的体积（GTV）外放10mm，80％～90％肿瘤周边剂量覆盖肿瘤靶区，每周3次，共5～8次，总量30～40Gy。部分患者配合外放疗和其他辅助治疗。结果 两组患者在进行3D-CRT和SRT治疗后均全部得到随访，1～3周内临床症状均有明显的改善，1～6个月生存质量明显提高，卡氏评分增加到70～90。治疗后1～6个月3D-CRT组影像学复查共35例，完全缓解23例（66％），部分缓解11例（31％），总有效率为97％；SRT组共37例，完全缓解25例（68％），部分缓解10例（27％），总有效率为95％，两种方法差异无统计学意义。1年生存率分别为74％和71％。结论 从放射物理学的角度比较，3D-CRT更适合治疗那些体积大、形态不规则的肿瘤，治疗计划的设计和治疗的时间短、疗效好、不良反应轻；SRT适合治疗那些中等大小、边缘规则、近似圆形的肿瘤，治疗计划的设计和治疗的时间长。
Objective To compare the therapecutic effects of 3D-confomal radiotherapy （3D-CRT） planning system based on numerical controlled multileaf equipment and stereotactic radiotherapy （SRT） planning system based on rotundity collimator in the tumor patients. Methods Of 81 patients with tumor （61 male, 20 famale） and the median age was 67.9 old years （27-89 years）. There were 29 cases of lung cancer,8 cardia and stomach cancer,7 liver cancer, 5 pancreas,and 32 other metastatic cancer. There were 4 cases of stage Ⅱ ,55 stage Ⅲ ,and 22 stage IV. The KPS score was 50-70. All patients were divided into two groups：41 cases in treatment group,and 40 cases in control group. The treatment group was treated for 3D-CRT planning system with MLC,and the control group treated with SRT planning system. All patients were treated with a dose of 30-40 Gy, 3 times a week. Target area was extended for 10 mm, and the marginal doseline is 80% -90%. A partial patients were treated with external beam combined with the other assistant treatment. Results After the treatment of 3D-CRT and SRT, the clinical symptoms of all patients were significantly better in 1 - 3 weeks, their life quality was significantly higher, and KPS score was improved to 70 - 90. After the treatment for 6 months,the callback result showed：CR was 66% （23/35） in 3D-CRT and CR 68% （25/37） in SRT,PR were 31% （11/35） and PR 27% （10/37） ,the overall availability rates were 97% in 3D-CRT and 95% in SRT,with no significant difference （P = 1. 000）. Conclusion The 3D-CRT planning system is better for the large and no-regnlar shap tumors. This technique is of advantages： shorter treatment times, better therapeatic effect and lower incident of side effect.
出处
《山西医药杂志》
CAS
2006年第7期600-602,共3页
Shanxi Medical Journal
关键词
肿瘤
放射外科手术
数控多叶准直装置
三维适形放射治疗
Neoplasms
Radiosurgery
Numerical controlled multileaf equipment
3D corLformal radiotherapy
