恶性肿瘤再程放疗18例的疗效和安全性观察

The Efficacy and Safety of Re-Irradiation for 18 Patients with Malignant Tumor

摘要: 目的：观察恶性肿瘤再程放疗的疗效及安全性。方法：回顾性分析18例接受再程放疗的患者，其中食管癌8例，鼻咽癌5例，椎体转移癌2例，宫颈癌、直肠癌和脑胶质瘤各1例，肿瘤靶区剂量30~50 Gy/10~25 f。结果：全组患者的随访时间为3~42个月，中位时间10个月。对存在可评价病灶者，在放疗结束后3个月时取得完全缓解(CR)者为50%(8例/16例)，部分缓解(PR)为31.2%(5例/16例)，1例稳定(SD)，1人未评估，另1人治疗无效，截至末次随访时间，无进展生存期为5~34个月；另2例椎体转移癌者再程放疗后疼痛症状都明显缓解。毒副反应总体上可耐受。结论：对于放疗后局部病情进展的恶性肿瘤患者，再程放疗有效、可靠。 Objective: To observe the efficacy and safety of re-irradiation for recurrent malignant tumor. Methods: Eighteen patients with recurrent malignant tumor were enrolled, in whom eight patients with esophageal cancer, five with nasopharyngeal cancer, two with spinal bone metastases, one with rectal cancer, one with cervical cancer and one with cerebral glioma. The total dose of GTV was 30 - 50 Gy with 2 - 3 Gy per fraction. Results: Median follow-up time was ten months (range 3 - 42 months). For the sixteen evaluable patients, eight patients had a complete response, five patients had a partial response, one patient had a stable disease, one patient did not receive the evaluation, the symptoms persisted for the last one after radiotherapy, and the time to progression was 5 - 34 months. Radiotherapy also brought considerable relief of pain in both patients with spinal bone metastases. Toxicity was generally tolerable and manageable. Conclusions: For the patients with recurrent tumor, re-irradiation was effective and reliable.