Kucuktulu E, Yurekli A F, Topbas M, Kece C, Guner A, Kucuktulu U
Consultant Oncologist, University of Health Sciences, Kanuni Research and Training Hospital, Dept of Radiation Oncology, Trabzon, Turkey. Email:
Asian Pac J Cancer Prev. 2019 Feb 26;20(2):595-599. doi: 10.31557/APJCP.2019.20.2.595.
Introduction: Previous studies comparing tomotherapy (TOMO) and three dimensional (3D) conformal radiotherapy (3DCRT) in gastric radiotherapy are limited and tend to be based on dosimetry. The aim of the present study was to evaluate the clinical outcomes of these two treatment modalities. Methods: A total of 51 patients diagnosed with gastric cancer who were treated with postoperative adjuvant chemoradiotherapy and had subtotal/total gastrectomy and D2 lymphatic dissection were recruited to the present study: 30 patients were treated with TOMO and 21 patients were treated with 3DCRT. Results: The 3DCRT and TOMO treatment regimens were compared. There was no difference in planning target volume (PTV) 95%, but TOMO was statistically significant in regard to PTV 105% (P<0.05). TOMO was also significantly different when compared with 3DCRT when evaluating liver mean dose, liver V40, right/left kidneys mean dose, right/left kidneys V20 and spinal cord mean dose values (P<0.05). Grade 2 acute side effects were more frequent (85.7%) following 3DCRT. In addition, the median overall survival time for TOMO treated patients was 62 months while in 3DCRT treated patients it was 22.05 months. The difference in disease free survival was also significantly increased in patients treated with TOMO (66.7% vs. 19.0%; P<0.05). Conclusion: TOMO treatment resulted in lower acute side effects with better patient survival following gastric cancer radiotherapy.
以往比较螺旋断层放疗（TOMO）和三维适形放疗（3DCRT）在胃癌放疗中应用的研究有限，且往往基于剂量学。本研究的目的是评估这两种治疗方式的临床疗效。方法：本研究共纳入51例接受术后辅助放化疗、行胃次全/全胃切除术及D2淋巴结清扫的胃癌患者：30例接受TOMO治疗，21例接受3DCRT治疗。结果：对3DCRT和TOMO治疗方案进行比较。计划靶区体积（PTV）95%时无差异，但PTV 105%时TOMO具有统计学意义（P<0.05）。在评估肝脏平均剂量、肝脏V40、右/左肾平均剂量、右/左肾V20和脊髓平均剂量值时，TOMO与3DCRT相比也有显著差异（P<0.05）。3DCRT后2级急性不良反应更常见（85.7%）。此外，接受TOMO治疗患者的中位总生存时间为62个月，而接受3DCRT治疗患者的为22.05个月。接受TOMO治疗患者的无病生存率差异也显著增加（66.7%对19.0%；P<0.05）。结论：TOMO治疗在胃癌放疗后导致更低的急性不良反应，患者生存率更高。
