立体定向放疗配合热疗及增敏剂治疗复发软组织肉瘤疗效观察

发布时间：2018-08-13 12:19

【摘要】：目的:评估体部伽玛刀配合热疗及增敏剂治疗复发及转移性软组织肉瘤的疗效与安全性。方法:选取自2012年1月至2014年3月中国人民解放军海军总医院肿瘤诊疗中心收治的63例复发及转移软组织肉瘤患者。采用立体定向体部伽玛射线放射治疗系统(体部伽玛刀)治疗,处方等剂量线采用55%~70%等剂量线包绕计划靶区;单次剂量4~5.5 Gy/次,治疗10~13次,总放射剂量44~55 Gy。所有患者均给予放射增敏剂治疗,增敏剂使用注射用甘氨双唑钠,每次1.00~1.50 g静脉滴注,隔日1次,伽玛刀治疗前0~3 h给药,共5~6次。30例患者配合热疗,自伽玛刀治疗后开始,每次1 h,每周2次,共6次,每次热疗在伽玛刀治疗后4 h内进行。结果:治疗后3个月总有效率为77.7%;伽玛刀联合增敏组的1、2年局部控制率分别为78.8%和63.6%,1、2年生存率分别为75.7%和63.6%;伽玛刀联合增敏及热疗组的1、2年局部控制率分别为83.6%和70.0%,1、2年生存率分别为80.0%和63.3%;随访期内未见严重放射性并发症。结论:对复发性软组织肉瘤采用伽玛刀配合热疗及增敏剂进行治疗是较有效的局部治疗方式。
[Abstract]:Objective: to evaluate the efficacy and safety of body gamma knife combined with hyperthermia and sensitizer in the treatment of recurrent and metastatic soft tissue sarcoma. Methods: from January 2012 to March 2014, 63 patients with recurrent and metastatic soft tissue sarcoma were selected. The stereotactic gamma ray radiotherapy system (body gamma knife) was used to treat the patients. The prescription isodose line was used to wrap the planned target area with 55% isodose line, and the single dose of 45.5 Gy/ was 105.13 times, the total radiation dose was 4455 Gy. All the patients were treated with radiosensitizer. The sensitizer was given intravenously by intravenous drip of 1.000.50g / time, once every other day, and the drug was given 3 hours before gamma knife therapy. A total of 56 patients were treated with hyperthermia since the beginning of Gamma knife therapy. Each time 1 hour, 2 times a week, 6 times, each time hyperthermia took place within 4 hours after gamma knife treatment. Results: the total effective rate was 77.7% 3 months after treatment, the 1- and 2-year local control rates were 78.8% and 63.6%, respectively, and the 2-year survival rates were 75.7% and 63.6% in gamma knife plus sensitization group and hyperthermia group, respectively, and the local control rates for 1 and 2 years in gamma knife combined sensitization group and hyperthermia group were 83.6%, respectively. The 1- and 2-year survival rates were 80.0% and 63.3%, respectively. Conclusion: gamma knife combined with hyperthermia and sensitizer is an effective local treatment for recurrent soft tissue sarcoma.
【作者单位】：中国人民解放军海军总医院肿瘤诊疗中心;
【分类号】：R738

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