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首页> 外文期刊>World Journal of Gastroenterology >Evaluation of intraoperative radiotherapy for gastric carcinoma with D2 and D3 surgical resection
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Evaluation of intraoperative radiotherapy for gastric carcinoma with D2 and D3 surgical resection

机译：D2和D3手术切除术对胃癌术中放疗的评价

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摘要

AIM: To study the proper sites and doses of intraoperative radiotherapy (IORT) for gastric carcinoma and the effects of this treatment. METHODS: A total of 106 patients with stage Ⅰ -Ⅳ gastric carcinoma who received D2 or D3 radical operation combined with IORT were analyzed. Sixty-seven patients with gastric cancer of the antrum and body underwent distal gastrectomy. The sites of irradiation were at the celiac artery and hepatoduodenal ligment area. Another 39 patients with carcinoma of the cardia and upper part of the gastric body and whole stomach underwent proximal gastrectomy or total gastrectomy. The sites of irradiation for this group were the upper margin of the pancreas and the regional para-aorta. The therapeutic effects (including survival and complications) of these 106 cases received operation combined with IORT (IORT group) were compared with 441 cases treated during the same time period by a radical operation alone (operation group). RESULTS: The radiation dose below 30 Gy was safe. The therapeutic method of the operation combined with IORT did not prolong the survival of patients with stage Ⅰ and Ⅳ gastric cancer, but the 5-year survival rates of patients with stage Ⅱ and Ⅲ gastric cancers were significantly improved. The 5-year survival rates of the stages Ⅲ cancer patients receiving D2 resection combined with IORT were markedly improved, while for those receiving D3 radical resection, only the postoperative 3- or 4-year survival rates were improved (P < 0.005-0.001). The 5-year survival rate for those patients was raised only by 4.7% (P > 0.05). CONCLUSION: The 5-year survival rates of patients with stages Ⅱ and Ⅲ gastric carcinoma who received D2 lymphadenectomy combined with IORT were improved, and there was no influence on the postoperative complications and mortality.
机译：目的：研究胃癌术中放疗（IORT）的正确部位和剂量及其治疗效果。方法：对106例D2或D3根治性手术联合IORT的Ⅰ〜Ⅳ期胃癌患者进行分析。 67名胃窦和胃癌患者接受了远端胃切除术。照射部位在腹腔动脉和十二指肠结扎区。另有39例carcinoma门癌，胃体上部和整个胃癌患者接受了近端胃切除术或全胃切除术。该组的照射部位是胰腺的上缘和主动脉旁区域。将106例接受IORT联合手术的患者（IORT组）的治疗效果（包括生存率和并发症）与同期单纯根治性手术治疗的441例患者（手术组）进行了比较。结果：30 Gy以下的辐射剂量是安全的。 IORT联合手术治疗不能延长Ⅰ，Ⅳ期胃癌患者的生存期，但Ⅱ，Ⅲ期胃癌的5年生存率明显提高。接受D2切除联合IORT的Ⅲ期癌症患者的5年生存率显着提高，而接受D3根治性切除的那些癌症患者，仅术后3年或4年生存率有所提高（P <0.005-0.001） 。这些患者的5年生存率仅提高了4.7％（P> 0.05）。结论：D2淋巴结清扫术联合IORT治疗的Ⅱ，Ⅲ期胃癌患者5年生存率提高，对术后并发症及死亡率无影响。

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