| 张月芬 王文然 杨玉刚 郑超 白鸽 玛依努尔·艾力△.多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响[J].,2017,17(7):1277-1280 |
| 多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响 |
| Effects of Multiple Field Irradiation, Three Dimensional Conformal RadiationTherapy and IntensityModulated Radiation Therapy on the SurroundingTissues of Gastric Cancer |
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| DOI： |
| 中文关键词: 多野照射 三维适形放疗 胃癌根治术 胃癌 调强放疗 |
| 英文关键词: Multiple field irradiation Three dimensional conformal radiotherapy Radical operation of gastric cancer Gastric cancer Intensity modulated radiation therapy |
| 基金项目:新疆医科大学科研创新基金项目（XJC201379） |
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| 中文摘要: |
| 目的：探讨多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响。方法：选取收治的103例行胃癌根治
术的患者，将所有患者随机分为甲乙丙三组，其中甲组患者34 例，均采用多野照射治疗；而乙组患者也是34例，均使用三维适形
放疗；丙组患者则有35 例，均使用调强放疗。观察比较各组患者放疗后的上腹部症状改善情况，并且检测各组患者的肝功能和血
常规以及胰淀粉酶等临床指标，比较各组患者经治疗后的复发率以及生存率。结果：甲组患者的近期疗效显著低于乙组患者（P＜
0.05），而乙组患者的近期疗效则明显低于丙组患者（P＜0.05）；三组患者的钡餐造影均有所改善，但是其组间比较差异不具有统
计学意义（÷ 2=9.012，P＞0.05）。甲组的不良反应率显著高于乙组和丙组（均P＜0.05），并且各组患者的不良反应中血常规异常的
发生率显著高于肝功能和胰脏功能的异常（均P＜0.05），同时甲组患者出现放射性脊髓病的患者明显多于乙组(P＜0.05)，仅丙组
患者未见放射性脊髓病。随访三年间三组患者第一年随访生存率无明显差异（P＞ 0.05），而在第2 年至第3 年则三组患者的随访
生存率有明显差异（均P＜0.05），其中随访生存率以丙组患者最高，其次为乙组患者；另外随访三年间甲组患者的随访复发率显
著高于乙组和丙组患者（均P＜0.05），其复发率由低至高依次为丙组＜乙组＜甲组。结论：与多野照射治疗相比，三维适形放疗和
调强放疗均能够更好地降低对胃癌周围组织的损伤和改善患者的临床症状，并且不良反应发生率低，对于降低复发率和提高生
存率方面亦有不错的效果。 |
| 英文摘要: |
| Objective:To investigate the effects of multiple fields irradiation, three dimensional conformal radiotherapy and intensity
modulated radiation therapy on the surrounding tissues of patients with gastric cancer.Methods:Selected from our hospital 103 patients
with gastric cancer radical surgery. All the patients were randomly divided into three groups, including 34 cases of patients in group
A using multiple fields irradiation therapy, 34 cases in group B using 3D conformal radiotherapy, and 35 cases in group C using intensity-
modulated radiotherapy. Observe and compare the upper abdominal symptoms improvement after radiotherapy in each group, and detect
clinical indexes in patients like liver function, blood routine and pancreatic amylase, compare the recurrence rate and survival rate after
treatment.Results:The short-term curative effects of patients in group A was significantly lower than that of patients in group B
(P<0.05), and the short-termcurative effects of the patients in group B was significantly lower than that of patients in group C (P < 0.05).
The barium meal results of patients in three groups were improved, but there were no statistical differences between groups (x2=9.012,
P>0.05). The adverse reaction rate was significantly higher in group A than in group B and groupC (P<0.05). And in each group, the incidence
rate of abnormal blood routine was significantly higher than that of abnormal pancreas and liver function (P<0.05). There were
more patients in group A with first appeared radiation myelopathy than in groupB (P<0.05). No radioactive spinal cord disease was observed
in patients of group C. During the three years of follow-up, the survival rate in the first year had no significant difference between
three groups (P>0.05). But, the survival rate was significantly different in the second and third year (P<0.05), in which the survival rate
was the highest in group C, and lowest in group A. Moreover, the recurrence rate was significantly higher in group A than in group B and
group C during the three-year follow up (all P<0.05), and also higher in group B than in group C.Conclusion:Compared with the treatment
of multiple fields irradiation, three-dimensional conformal radiotherapy and intensity modulated radiotherapy can better reduce the gastric cancer surrounding tissue damage and adverse reactions occurrence rate, and improve clinical symptoms of patients. The two
methods also had good results in reducing the recurrence rate and improving survival rate. |
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