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目的：探讨胃癌术中照射部位、剂量和治疗结果。方法：对１０６例Ⅰ－Ⅳ期胃癌患者行Ｄ２或选择性Ｄ３术式，并采用不同照射剂量进行术中照射。对胃窦、体癌患者施行远侧胃大部切除术时，在腹腔动脉和肝十二指肠韧带区域进行术中照射。在胃体、贲门和全胃癌施行近侧胃大部切除或全胃切除时，将脾、胰体尾游离并翻向右侧，扩大术中照射野。此组病例的放疗结果与１９７５年至１９８９年期间４４１例胃癌单纯手术患者进行对照。结果：Ⅰ、Ⅳ期胃癌术中放疗不能提高术后生存期，Ⅱ、Ⅲ期胃癌能提高５年生存率１４．４％～２０％。其中Ⅲ期胃癌采用Ｄ２术式加术中放疗１～５年生存率有显著提高（Ｐ＜０．００１），而采用选择性Ｄ３手术加术中放疗术后３、４年生存率较单纯选择性Ｄ３显著提高（Ｐ＜０．００５）。结论：胃癌术中放疗能提高Ⅱ、Ⅲ期胃癌术后生存率，不增加术后并发症和死亡率。
Objective: To explore the intraoperative irradiation site, dose and treatment outcome of gastric cancer. Methods: Sixty-six patients with stage I-IV gastric cancer were treated with D2 or selective D3, and different irradiation doses were used for intraoperative radiation. In patients with gastric antrum and body cancer undergoing distal gastrectomy, intra-operative irradiation was performed in the celiac artery and hepatoduodenal ligament area. In the gastric body, cardia, and total gastric cancer when the proximal gastrectomy or total gastrectomy, the spleen, pancreatic body and tail free and turn to the right, expand the intraoperative radiation field. Radiotherapy results in this group of patients were compared with 441 patients with gastric cancer who had undergone surgery from 1975 to 1989. Results: Intraoperative radiotherapy for stage I and IV gastric cancer could not improve the postoperative survival period. Stage II and III gastric cancer could increase the 5-year survival rate by 14.4% to 20%. The survival rate of stage III gastric cancer with D2 surgery plus intraoperative radiotherapy was significantly improved (P<0.001), but the survival rate at the 3rd and 4th year after elective D3 surgery plus intraoperative radiotherapy was more simple than Sex D3 increased significantly (P < 0.005). Conclusion: Intraoperative radiotherapy of gastric cancer can improve the survival rate of patients with stage II and III gastric cancer without increasing postoperative complications and mortality.