Oehler W, Lessel A, Hüttner J
Arch Geschwulstforsch. 1987;57(1):53-60.
Local recurrence in anastomotic region after resection of stomach cancer is not a rare event. The role of radiotherapy in palliative treatment is commonly underestimated. Our experiences were demonstrated in 2 treatment groups (megavoltage therapy alone, 23 cases; in combination with neutrons, 13 patients). Decrease in dysphagia in 75% of patients was comparable with roentgenologic findings, where reduced tumor in 63% was established. These encourageable findings were confirmed in examination of anastomotic region in autopsy (megavoltage therapy 14 cases, combined neutron therapy 12 cases). Smaller tumors could be totally destroyed by megavoltage therapy. The local tumor destroying rate increased by combination with neutrons (6/12 cases). No advantage in life prolongation could be stated, because local recurrence was quickly followed by widespread disease (77%). Finally we demonstrate a treatment plan, which bases on our clinical experience. With 3-4 fractions of 5-7 Gy a real clinical and radiological demonstrable palliation effect is to be reached.
胃癌切除术后吻合口区局部复发并非罕见。放疗在姑息治疗中的作用通常被低估。我们的经验体现在两个治疗组中（单纯兆伏级放疗，23例；联合中子放疗，13例）。75%的患者吞咽困难减轻，这与X线检查结果相符，其中63%的患者肿瘤缩小。尸检时吻合口区检查证实了这些令人鼓舞的结果（兆伏级放疗14例，联合中子放疗12例）。兆伏级放疗可使较小肿瘤完全被摧毁。联合中子放疗可提高局部肿瘤摧毁率（12例中有6例）。由于局部复发后很快出现广泛转移（77%），因此无法说明在延长生命方面有优势。最后，我们展示了一个基于临床经验的治疗方案。给予3 - 4次分割，每次5 - 7 Gy，可达到实际临床和放射学可证实的姑息治疗效果。
