泌尿外科杂志（电子版）
泌尿外科雜誌（電子版）
비뇨외과잡지（전자판）
JOURNAL OF UROLOGY FOR CLINICIAN(ELECTRONIC VERSION)
2015年
3期
50-54
,共5页
刘仙明%郭建平%王晓燕%周尔玺
劉仙明%郭建平%王曉燕%週爾璽
류선명%곽건평%왕효연%주이새
立体定位技术%三维适形%膀胱肿瘤
立體定位技術%三維適形%膀胱腫瘤
입체정위기술%삼유괄형%방광종류
Stereotactic Body Radiotherapy%3-D conformal%Bladder tumor
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 cGy，每周5次，共13～15次，PTV周边总剂量3650～4200 cGy。17人采用三维适形放疗，每次200 cGy，每周5次，共25～30次，PTV周边总剂量5000～6000 cGy，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。
目的：分析比較採用立體定嚮放療或三維適形放療治療膀胱癌的療效與併髮癥。方法近7年43例膀胱癌患者在本科室行立體定嚮放療或三維適形放療，其中26人採用立體定嚮放療，每次280 cGy，每週5次，共13～15次，PTV週邊總劑量3650～4200 cGy。17人採用三維適形放療，每次200 cGy，每週5次，共25～30次，PTV週邊總劑量5000～6000 cGy，所有患者治療結束後3箇月行膀胱鏡和CT檢查評價短期療效，隨訪3～36箇月，以觀察遠期治療效果及不良反應髮生情況。結果所有病人血尿癥狀減輕或消失，立體定嚮放療組，CR5例，PR11例。三維適形放療組，CR2例，PR7例。2組的短期療效有差異（P＝0．022），放療後膀胱內複髮27例，均再次行立體定嚮放療或三維適形放療。2組中位生存時間分彆為18．00箇月和16．00箇月。立體定嚮放療組晚期泌尿繫統反應高于三維適形放療組（P ＝0．033），三維適形放療組急性消化繫統反應高于立體定嚮放療組（P＝0．024）。結論膀胱癌採用立體定嚮放療可以穫得較三維適形放療更好的跼部控製率，延長FPS，採用立體定嚮放療晚期泌尿繫統反應較重，但急性消化繫統反應較輕。
목적：분석비교채용입체정향방료혹삼유괄형방료치료방광암적료효여병발증。방법근7년43례방광암환자재본과실행입체정향방료혹삼유괄형방료，기중26인채용입체정향방료，매차280 cGy，매주5차，공13～15차，PTV주변총제량3650～4200 cGy。17인채용삼유괄형방료，매차200 cGy，매주5차，공25～30차，PTV주변총제량5000～6000 cGy，소유환자치료결속후3개월행방광경화CT검사평개단기료효，수방3～36개월，이관찰원기치료효과급불량반응발생정황。결과소유병인혈뇨증상감경혹소실，입체정향방료조，CR5례，PR11례。삼유괄형방료조，CR2례，PR7례。2조적단기료효유차이（P＝0．022），방료후방광내복발27례，균재차행입체정향방료혹삼유괄형방료。2조중위생존시간분별위18．00개월화16．00개월。입체정향방료조만기비뇨계통반응고우삼유괄형방료조（P ＝0．033），삼유괄형방료조급성소화계통반응고우입체정향방료조（P＝0．024）。결론방광암채용입체정향방료가이획득교삼유괄형방료경호적국부공제솔，연장FPS，채용입체정향방료만기비뇨계통반응교중，단급성소화계통반응교경。
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.
