重离子束治疗恶性黑色素瘤临床研究及疗效观察

摘要

目的:探讨我国自主研发的重离子加速器照射恶性黑色素瘤(MM)的临床疗效.方法:4例MM(3例术后复发,1例初治)自愿接受重离子照射的患者,1例位于下眼睑及内眦,1例位于大腿,1例位于腹股沟,1例位于足跟部及胭窝.2006-11～2008-09应用80～100 mev/U,<'12>C<'6+>重离子束,4例分别给于总剂量72～120.3 GyE/6～13 F照射(RBE=3).结果:4例照射7个部位,3例4个部位肿块完全消失,达CR,另l例3个部位均缩小75%,达PR,有效率100%,疗中及疗后,皮肤有轻、中度早反应改变.3例3年以上者随访局部肿块消失,均无远处转移.结论:<'12>C<'6+>重离子具有治疗精度高、疗程短,疗效显著等特点,特别在MM等射线抗拒的难治性肿瘤中,可达到常规放射治疗难以实现的效果.%Objective: To explore the clinical effect of heavy ion synchrotron developed independently on malignant melanoma (MM).Methods: During Jan.2007 to Sep.2008, four patients (3 cases recurrence after operation, one case without any treatment) with MM received irradiation (dose 72 - 120.3 GyE/6 - 13F, RBE = 3) by carbon ion 12C6+ (80 - 100 mev/U).The lesions located in lower eyelid and canthus ( 1 case), thigh ( 1 case),groin ( 1 case), posterior heel and popliteal fossa ( 1 case), respectively.Results: Seven lumps received irradiation, 4 lumps in 3 patients completely disappeared (reach CR), while 3 lumps in 1 patient reduced by 75％ (reach PR).The effective rate was 100％.During and after the treatment, there were some slight and mild skin side reactions.Lumps in 3 patients disappeared more than 3 years without invasion and metastasis.Conclusion:Carbon ion therapy is useful with higher therapeutic precision and shorter course of treatment in refractory tumors including MM.It offers a peerless therapeutic effect compared to routine radiotherapy.