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3种放疗方式用于胃癌术后的近中期疗效及对周围组织的损伤情况
作者:方亮 
单位:新汶矿业集团中心医院肿瘤科  山东 新泰 271219 
关键词:胃肿瘤/放射疗法 胃肿瘤/外科学 放射疗法 适形 放射疗法 调强适形 手术后期间 放射疗法/方法 创伤和损伤 治疗结果 
DOI:R735.2;R730.55
出版年,卷(期):页码:2015,30(4):367-370
摘要:
目的 比较二维多野照射、三维适形放射治疗(3-dimensional conformal radiotherapy,3DCRT)、调强放射治疗(intensity modulated radiation therapy,IMRT)3种放疗方式用于胃癌术后的近中期疗效及对周围组织的损伤情况。方法 统计分析75例术后随机行二维多野照射、3DCRT或IMRT治疗的胃癌患者的临床资料(各25例)。结果 3DCRT组和IMRT组患者的不适症状完全缓解率和改善率均高于二维多野照射组(均P<0.05);3DCRT组和IMRT组患者的2、3年生存率均高于二维多野照射组(均P<0.05),复发率均低于二维多野照射组(均P<0.05);IMRT组患者的2、3年生存率均高于3DCRT组(均P<0.05),复发率均低于3DCRT组(均P<0.05);3DCRT组和IMRT组患者的白细胞下降、中性粒细胞比例增高、胰淀粉酶升高、转氨酶升高、放射性脊髓病发生率均低于二维多野照射组(均P<0.05);IMRT组患者的周围组织不良反应的发生率均低于3DCRT组(均P<0.05)。结论 在胃癌术后的近中期疗效方面,IMRT优于3DCRT,二维多野照射较差;在对周围组织的损伤方面,IMRT最轻,3DCRT其次,二维多野照射损伤较大。
Objective To evaluate the short/mid-term efficacy and adverse reactions of three postoperative radiotherapy modalities for patients with gastric cancer. Methods Seventy-five patients with gastric cancer were randomly divided into 3 groups (each n=25), receiving multi-field irradiation (MFI), 3-dimensional conformal radiation therapy (3DCRT), or intensity-modulated radiation therapy (IMRT) after operation respectively. Clinical efficacy and adverse reactions were evaluated and compared among 3 groups. Results The symptom remission rates in 3DCRT and IMRT groups were significantly higher than that in MFI group (both P<0.05). The 2-and 3-year survival rates in 3DCRT and IMRT groups were significantly higher and the recurrence rates were significantly lower than those in MFI group (all P<0.05). The 2-and 3-year survival rates in IMRT group were significantly higher and the relapse rate was significantly lower than those in 3DCRT group (all P<0.05). The incidence rates of adverse reactions (including leukopenia, radioactive myelopathy and the increase of neutrophil percentage, pancreatic amylase level and aminotransferase level) in 3DCRT and IMRT groups were significantly lower than those in MFI group (all P<0.05);the incidence rate of surrounding tissue toxicity in IMRT group was significantly lower than that in 3DCRT group (all P<0.05). Conclusions Among three postoperative radiotherapy modalities for gastric cancer patients, IMRT has the best short/mid-term efficacy and least adverse reactions. MFI has the worst short/mid-term efficacy and most adverse reactions.
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