Polico R, Stea L, Antonello M, Princivalli M, Marchetti C, Busetto M, Schiavon S, Pizzi G
Divisione di Radioterapia Oncologica, Ospedale Umberto I, Mestre, Venezia.
Radiol Med. 1995 Jul-Aug;90(1-2):113-23.
The coplanar polycentric multiple 180 degrees single arc and narrow beams technique (PMA) allows high radiation doses to be delivered to the target, with similar dose distribution to that of brachytherapy. Since 1990, more than 100 patients have been treated: 80 had NSCLC, 12 had epidermoid head and neck (oral cavity and oropharynx) cancers, 8 brain tumors, 4 esophageal cancers and, sporadically, other patients had many other kinds of tumors, e.g., Hodgkin's and non-Hodgkin's lymphomas and sarcomas. X photons of a 12-MV Linac have always been used. NSCLC patients are assessable for local control, toxicity and survival, while the other patients only for local control and/or toxicity. As for 31 stage I-II lung cancer patients, CR has been observed in 82.8% of them and PR in 13.8%; the response was always assessed with chest radiography, CT, FBS, cytology and/or histology. The overall actuarial survival rate is 71% at 40 months, the disease-free survival rate is 75% and the local progression-free survival rate is 94%. As for 49 stage-III patients, CR has been observed in 40% of them and PR in 56%. The overall disease-free survival is 10% at 28 months (median survival: 14.37 +/- 0.6 months). The disease-free survival rate is 23%. The local progression-free survival rate is similar to the overall survival rate, which seems to prove the very high metastatic spread of this disease in advanced stages. Twelve head and neck cancer patients have been treated, 5 of them in stage II and 7 in stage IV. CR has been observed in all the patients in lower stages (100%), in 4/7 patients in stage IV (57%) and in 4/5 patients (80%) in the T4N0 subgroup. The response of brain tumors treated with the PMA technique is difficult to assess because radiographic, CT and MR images are difficult to correlate with patients clinical status. The patients in our series are still alive, with a medium follow-up of 7 months (range: 2-16 months). A longer follow-up is necessary before any other considerations on the effectiveness of this method can be made. This technique was used on the patients who were not eligible for the other techniques with high doses delivered to the tumor, because of its volume and/or shape. Four esophageal cancers were treated with palliative intent, because of absolute dysphagia, in alternative to HDR brachytherapy. All these patients have obtained symptom remission.(ABSTRACT TRUNCATED AT 400 WORDS)
共面多中心多180度单弧窄束技术（PMA）能够向靶区给予高剂量辐射，其剂量分布与近距离放疗相似。自1990年以来，已治疗100多名患者：80例为非小细胞肺癌（NSCLC），12例为表皮样头颈部（口腔和口咽）癌，8例为脑肿瘤，4例为食管癌，偶尔还有其他患者患有多种其他类型的肿瘤，如霍奇金淋巴瘤和非霍奇金淋巴瘤以及肉瘤。一直使用12兆伏直线加速器产生的X光子。NSCLC患者可评估局部控制、毒性和生存率，而其他患者仅评估局部控制和/或毒性。对于31例I-II期肺癌患者，82.8%观察到完全缓解（CR），13.8%观察到部分缓解（PR）；总是通过胸部X线摄影、CT、FBS、细胞学和/或组织学评估反应。40个月时的总精算生存率为71%，无病生存率为75%，局部无进展生存率为94%。对于49例III期患者，40%观察到CR，56%观察到PR。28个月时的总无病生存率为10%（中位生存期：14.37±0.6个月）。无病生存率为23%。局部无进展生存率与总生存率相似，这似乎证明了该疾病在晚期有非常高的转移扩散率。已治疗12例头颈部癌患者，其中5例为II期，7例为IV期。在较低分期的所有患者（100%）、IV期的4/7患者（57%）和T4N0亚组的4/5患者（80%）中观察到CR。用PMA技术治疗的脑肿瘤反应难以评估，因为X线摄影、CT和MR图像难以与患者的临床状况相关联。我们系列中的患者仍然存活，中位随访时间为7个月（范围：2-16个月）。在对该方法的有效性做出任何其他考虑之前，需要更长时间的随访。由于肿瘤的体积和/或形状，该技术用于那些不符合其他高剂量肿瘤放疗技术条件的患者。4例食管癌因绝对吞咽困难而采用姑息性治疗，替代高剂量率近距离放疗。所有这些患者均获得症状缓解。（摘要截断于400字）
