朗格汉斯组织细胞增生症放射治疗的临床研究

摘要

langerhans'cell histiocytosis( LCH) is a rare pathology that affects different structures of the human body. Specially bone tissue. The objective of this stud; is to explores the best radiotherapy dose and patient's prognosis. Methods A retrospective study was conducted from 1986 to 2008 with 40 patients diagnosed and treated for a LCH of the bone at our department. Twenty patients diagnosed were stage I of LCH; 17 patients with 22 bone involvement were diagnosed stage II of LCH; and 3 patients were diagnosed stage ? of LCH. All patients were divided into two groups;one group was treated by high dose radiotherapy( =16Gy) and other group was treated by lower dose radiotherapy( < 16Gy). The rate of local disease control was compared between two groups. Results In stage I of patients, the rate of local disease control was 100% and 5 - year survival rate was 100% . In stage ? of patients,5 - year survival rate was 87% ,and the rate of local disease control was 86% . In stage ? of patients 5 -year survival rate was 67% (2/3) ,and the rate of local disease control was 100% (3/3). No difference between two groups in rate of local disease control was found (P -0.390).Conclusion The lower dose radiotherapy can effectively control the involvement bone, and wouldn't cause the serious complication. 3D radiotherapy was a effective method to treat a LCH of the bone which was residue or recurrence after chemotherapy and surgery.%目的 通过对一组临床资料研究,来探索朗格汉斯组织细胞增生症(LCH)放射治疗的最佳剂量和患者的预后情况.方法 回顾性研究笔者所在科室自1986～2008年收治的40例诊断为LCH伴有骨组织病变患者,Ⅰ期患者20例,有20个放疗部位；Ⅱ期患者17例,有22个放疗部位；Ⅲ期患者3例.把以上病例分为高剂量组(≥16Gy)和低剂量组(＜16Gy),然后比较两组的疗效.结果 Ⅰ期患者局部病灶控制率为100％,5年生存率100％.Ⅱ期的患者局部病灶控制率为86％,5年生存率87％.Ⅲ期的患者局部病灶控制率为100％( 3/3),5年生存率67％(2/3).两组的疗效没有统计学意义(P=0.390).结论 低剂量的放射治疗能够有效地控制局部病灶,而不会导致严重的并发症,三维适形放射治疗是治疗LCH局部骨病变及化疗和手术后残余病灶的一个有效的手段.