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[术中放疗在小儿肿瘤外科手术中的作用]

[The role of intraoperative radiotherapy in oncological pediatric surgery].

作者信息

Barrientos G, Estellés C, Calvo F, Cantalejo A, Sánchez R, Romero R, Galarón P, Cela E, Vázquez J

机构信息

Servicio de Cirugía Pediátrica, Hospital Infantil Universitario Gregorio Marañón, Madrid.

出版信息

Cir Pediatr. 1999 Oct;12(4):136-9.

Abstract

Conventional external beam radiation has proved its profit in pediatric tumors; but its complications have limited it in therapeutical approach. Intraoperative radiotherapy delivers a high single dose in residual tumor or high risk areas during surgery. In our center, during last two years, 7 patients have been candidates to surgery with intraoperative radiotherapy (the age range was between 5 months-17 years; mean 8.5 years). Two patients were excluded of our protocol because of their intraoperative stage. Patients tumors types were: neuroblastoma (n = 3; stage III and IV), soft tissue sarcomas (n = 1) and Ewing's sarcoma (n = 1). The radiation doses ranged from 500 cGyto-1200 cGy. Local control tumor was achieved in 4 patients and no-complications were present secondary to surgery or intraoperative radiotherapy. Intraoperative radiotherapy seems to be a feasible treatment which might promote local control in pediatric tumors with protection of normal tissues and could be an excellent complement in special cases.

摘要

传统外照射放疗已在儿童肿瘤治疗中证明其益处;但其并发症限制了它在治疗方法中的应用。术中放疗在手术期间对残留肿瘤或高危区域给予高单次剂量照射。在我们中心,过去两年间,有7例患者成为术中放疗手术的候选对象(年龄范围在5个月至17岁之间;平均8.5岁)。有2例患者因术中分期被排除在我们的方案之外。患者的肿瘤类型为:神经母细胞瘤(n = 3;III期和IV期)、软组织肉瘤(n = 1)和尤因肉瘤(n = 1)。放射剂量范围为500 cGy至1200 cGy。4例患者实现了局部肿瘤控制,手术或术中放疗均未引发并发症。术中放疗似乎是一种可行的治疗方法,它可能在保护正常组织的同时促进儿童肿瘤的局部控制,并且在特殊情况下可能是一种极佳的补充治疗手段。

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