摘要
目的确认Ⅰ期胸腺瘤根治术后是否常规行放射治疗。材料与方法前瞻性随机分组研究，１９８１年８月至１９９６年１月，２９例根治术后Ⅰ期胸腺瘤患者入组研究。单一手术组１３例，术后放疗组１６例，年龄≤６５岁。肿瘤在包膜内生长，大体与镜下包膜未受侵。术后放疗组病例，在术后４周内接受放射治疗。放射源８ＭＶ－Ｘ线。多为２个前斜野加楔形板照射，放疗区域为原瘤床区。淋巴细胞为主型照射ＤＴ５０Ｇｙ／５周，上皮或混合细胞型ＤＴ６０Ｇｙ／６周。生存率统计为卡—迈曲线。结果两组均无复发或转移，术后放疗组无严重放射副反应。单一手术组５年和１０年生存率均为９２％，术后放疗组均为８８％，差异无统计学意义。３例死亡，其中１例死于重症肌无力（Ｍｙａｓｔｈｅｎｉａｇｒａｖｉｓ，ＭＧ），２例死于其它疾病。放射治疗未缓解ＭＧ。结论Ⅰ期胸腺瘤无需术后放疗。
Purpose To determine the effects of postoperative radiotherapy for stage Ⅰ thymoma.Materials and Methods From August 1981 to January 1996,29 patients with stage Ⅰ thymoma and age ≤ 65 years were randomized into two groups:surgery alone (13 patients) and postoperative radiotherapy (16 patients). Staging classification was based on the surgical and pathologic criteria that stage Ⅰ was the tumor had complete capsule macroscopically and no capsular invasion microscopically. Adjuvant radiotherapy was started within 4 weeks after surgery.Megavoltage radiation ,using the isocentric technique,was administered by an anterior field and /or two anterior oblique wedge fields. Radiation doses to the tumor bed were 50 Gy in 25 daily fraction over 5 weeks for the patients with lymphocytic predominant type,and 60 Gy in 30 daily fractions over 6 weeks for the patients with epithelial cell type or mixed type. The survival rates were estimated by the Kaplan Meier method.Results There was no recurrence and metastasis in either groups. No acute and late radiological injuries were found among the postoperative patients. Both of the 5 year and 10 year survivals were 92% for the patients treated by surgery alone, as compared with 88% by postoperative radiotherapy. There was no difference in the survival among the two groups. Of the 3 deaths,1 died of myasthenia gravis and 2 of intercurrent illness. No significant correlation was found between myasthenia gravis and radiotherapy.Conclusion The results show postoperative radiotherapy is unnecessary for patients with stage Ⅰ thymoma. Myasthenia gravis is not influenced by postoperative radiotherapy.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
1998年第4期218-221,共4页
Chinese Journal of Radiation Oncology
关键词
胸腺瘤
放射疗法
术后
Thymoma/radiotherapy Myasthenia gravis Prospective studies
