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目的探讨利用3D C R T技术治疗颅外肿瘤时大幅度提高分次量的可能性。方法回顾性分析总结300例颅外肿瘤的治疗计划。其中胸部肿瘤143例,腹部肿瘤157例。计划靶区体积7.0￣1478cm3,多数计划以90%的等剂量线包围PTV,少数以80%的等剂量线包围PTV的95%。以参考点剂量的90%为处方剂量,分次剂量多为5￣10G y,众数剂量为6￣8G y,疗程一般为5￣15d,间隔0￣1d,总剂量视情况给到常规治疗的根治量或姑息量,生物效应则增加10%￣40%。结果所有治疗计划均顺利完成,患者未出现影响生存质量的并发症。结论由于f因子的作用,3D C R T使得较大幅度增加分次量,缩短总疗程,提高放射的生物效应成为可能;对于体积较大的肿瘤在治疗开始时应积极考虑使用3D C R T技术;由于认知水平有限,使用3D C R T技术不宜过分追求精确计划、精确设计、精确治疗;使用3D C R T技术治疗颅外肿瘤时视治疗目的的不同,给予常规放疗2￣3倍的分次量是安全、可靠、有效的。
Objective To explore the possibility of using 3D C R T technique to significantly improve the fractionation of extracranial tumors. Methods Retrospective analysis of 300 cases of extracranial tumors treatment plan. 143 cases of chest tumor and 157 cases of abdominal tumor. The target volume is planned to be 7.0-1478 cm3. Most plans encompass PTVs with 90% isodose lines and a few with 95% of PTVs with 80% isodose lines. The reference dose of 90% of the prescription dose, fractional dose of mostly 5 ~ 10Gy, the mode of dose of 6 ~ 8Gy, treatment is generally 5 ~ 15d, interval 0 ~ 1d, the total dose as appropriate to the conventional treatment Of the radical or palliative, biological effects increased 10% ~ 40%. Results All treatment plans were successfully completed, and patients did not experience complications that affected the quality of life. Conclusion Due to the effect of f factor, 3D CRT makes it possible to increase fractionation by a large margin, shorten the total duration of treatment and improve the biological effect of radiation. For larger tumors, the use of 3D CRT should be actively considered at the beginning of treatment. The level of knowledge is limited, the use of 3D CRT technology should not be excessive pursuit of precise planning, precise design, precise treatment; the use of 3D CRT technology for the treatment of extracranial tumors, depending on the purpose of treatment, giving conventional radiotherapy 2 to 3 times the weight is safe and reliable ,Effective.