蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
Journal of Bengbu Medical College
2015年
10期
1346-1349
,共4页
葛宁%詹必红%常娜%臧春宝
葛寧%詹必紅%常娜%臧春寶
갈저%첨필홍%상나%장춘보
食管肿瘤%腹膜后转移瘤%替吉奥%伽马刀
食管腫瘤%腹膜後轉移瘤%替吉奧%伽馬刀
식관종류%복막후전이류%체길오%가마도
esophageal neoplasms%retroperitoneal lymph node metastasis%tegafur%gamma knife therapy
目的:探讨替吉奥(S1)联合体部伽马刀治疗食管癌腹膜后淋巴结转移的疗效及不良反应.方法:回顾性分析69例食管癌腹膜后淋巴结转移患者临床资料,体部伽马刀治疗时用真空垫和三维立体定向体架固定,增强CT扫描,肿瘤靶区外扩10 mm为计划靶区,50%等剂量线包绕95%计划靶区为处方剂量线,每次350~450 cGy,5次/周.10~12次完成.肿瘤边缘总剂量:4 200~4 950 cGy.69例中联合组36例,行体部伽马刀治疗联合口服S1 40 mg/m2 ,2次/天,口服21 d,28 d为1个周期,口服4个周期;对照组33例,单纯行体部伽马刀治疗.结果:联合组近期总有效率和1年生存率分别为86.11%、77.78%,对照组分别为63.63%、54.54%,联合组1 年生存率高于对照组(P<0.05).联合组疼痛缓解总有效率为91.18%,对照组77.42%,差异无统计学意义(P>0.05).2组患者治疗过程中的急性不良反应差异均无统计学意义(P>0.05),患者均可耐受,经积极治疗可好转,未发生治疗相关性病死亡.结论:S1联合体部伽马刀治疗食管癌腹膜后淋巴结转移可提高1年生存率,不良反应无明显增加.
目的:探討替吉奧(S1)聯閤體部伽馬刀治療食管癌腹膜後淋巴結轉移的療效及不良反應.方法:迴顧性分析69例食管癌腹膜後淋巴結轉移患者臨床資料,體部伽馬刀治療時用真空墊和三維立體定嚮體架固定,增彊CT掃描,腫瘤靶區外擴10 mm為計劃靶區,50%等劑量線包繞95%計劃靶區為處方劑量線,每次350~450 cGy,5次/週.10~12次完成.腫瘤邊緣總劑量:4 200~4 950 cGy.69例中聯閤組36例,行體部伽馬刀治療聯閤口服S1 40 mg/m2 ,2次/天,口服21 d,28 d為1箇週期,口服4箇週期;對照組33例,單純行體部伽馬刀治療.結果:聯閤組近期總有效率和1年生存率分彆為86.11%、77.78%,對照組分彆為63.63%、54.54%,聯閤組1 年生存率高于對照組(P<0.05).聯閤組疼痛緩解總有效率為91.18%,對照組77.42%,差異無統計學意義(P>0.05).2組患者治療過程中的急性不良反應差異均無統計學意義(P>0.05),患者均可耐受,經積極治療可好轉,未髮生治療相關性病死亡.結論:S1聯閤體部伽馬刀治療食管癌腹膜後淋巴結轉移可提高1年生存率,不良反應無明顯增加.
목적:탐토체길오(S1)연합체부가마도치료식관암복막후림파결전이적료효급불량반응.방법:회고성분석69례식관암복막후림파결전이환자림상자료,체부가마도치료시용진공점화삼유입체정향체가고정,증강CT소묘,종류파구외확10 mm위계화파구,50%등제량선포요95%계화파구위처방제량선,매차350~450 cGy,5차/주.10~12차완성.종류변연총제량:4 200~4 950 cGy.69례중연합조36례,행체부가마도치료연합구복S1 40 mg/m2 ,2차/천,구복21 d,28 d위1개주기,구복4개주기;대조조33례,단순행체부가마도치료.결과:연합조근기총유효솔화1년생존솔분별위86.11%、77.78%,대조조분별위63.63%、54.54%,연합조1 년생존솔고우대조조(P<0.05).연합조동통완해총유효솔위91.18%,대조조77.42%,차이무통계학의의(P>0.05).2조환자치료과정중적급성불량반응차이균무통계학의의(P>0.05),환자균가내수,경적겁치료가호전,미발생치료상관성병사망.결론:S1연합체부가마도치료식관암복막후림파결전이가제고1년생존솔,불량반응무명현증가.
Objective:To evaluate the effects and adverse reactions of the tegafur combined with body gamma knife in the treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis. Methods:The clinical data of 69 esophageal neoplasm patients with retroperitoneal lymph node metastases were retrospectively analyzed. Fixing vacuum pad and three-dimensional stereotactic body,enhancing CT scan,enlarging the tumor target area for 10 mm as planning target area,50% dose line embracing 95%planning target area as prescription dose curve and 350 to 450 cGy one time(5 times a week) were implemented at the time of body gamma knife therapy. The treatment was consist of 10 to 12 times,and the total dose of the tumor margin was 4 200-4 950 cGy. Among 69 cases,36 patients(combination group) were treated with the body gamma knife combined with tegafur(40 mg/m2,2 times 1 d, 28 days 1 cycle for 4 cycles) ,33 patients( control group) were only treated with the body gamma knife therapy. Results:The short-term effective rate and 1-year survival rate in the combination group and control group were 86. 11% &77. 78% and 63. 63% &54. 54%, respectively. The 1-year survival rate in the combination group was higher than that in the control group(P<0. 05). The total effective rate of pain relief in the combination group and control group were 91. 18% and 77. 42%,respectively,the difference of which was not statistically significant(P>0. 05). The difference of the acute adverse reaction between two groups was not statistically significant(P>0. 05). The patients could tolerate,and were improved after positive treatment. No case died. Conclusions:The treatment of patients with esophageal neoplasm complicated with retroperitoneal lymph node metastasis with tegafur combined with body gamma knife treatment can improve 1-year survival rate,and does not increase the adverse reaction of patients.
