Sindelar W F, Hoekstra H J, Kinsella T J
Surgery Branch, National Cancer Institute, Bethesda, MD 20892.
Surgery. 1988 Feb;103(2):247-56.
Eighty-five patients with locally advanced intra-abdominal, retroperitoneal, and pelvic malignant diseases have been treated at the National Cancer Institute (NCI) with electron beam intraoperative radiotherapy (IORT). In general, IORT was performed after resection to the tumor bed and to areas of locoregional spread. IORT was delivered directly to some unresectable tumors. The median survival for the entire NCI patient group was 13.9 months, with 34% of the patients projected to achieve local control of disease at 5 years. Multiple abutting IORT fields were used in 76% of the patients; they encompassed treatment areas as large as 569 cm2 and involved as many as five separate IORT applications. Multiple fields were matched along straight edges on the treatment applicators or provided by means of lead shielding strips. Areas of field overlap were prevented by the use of lead shields. Surgical approaches and radiotherapeutic techniques of multiple field matching have been developed and are detailed for carcinoma of the pancreas, carcinoma of the stomach, sarcomas of the retroperitoneum, carcinoma of the rectum, and tumors of the pelvic girdle.
美国国立癌症研究所（NCI）对85例局部晚期腹内、腹膜后和盆腔恶性疾病患者进行了电子束术中放射治疗（IORT）。一般来说，IORT在肿瘤切除后对瘤床和局部区域扩散部位进行。IORT也直接应用于一些无法切除的肿瘤。NCI患者组的中位生存期为13.9个月，预计34%的患者在5年时可实现疾病的局部控制。76%的患者使用了多个相邻的IORT野；这些野覆盖面积达569平方厘米，涉及多达5次单独的IORT照射。多个野在治疗施源器上沿直线边缘匹配，或通过铅屏蔽条实现匹配。通过使用铅屏蔽来防止野重叠区域。已开发出多野匹配的手术方法和放射治疗技术，并针对胰腺癌、胃癌、腹膜后肉瘤、直肠癌和骨盆带肿瘤进行了详细阐述。
