【摘要】 目的评价立体定向放射治疗对鼻咽癌放疗后复发或病变残存的疗效。方法对 5 0例鼻咽癌放疗后复发或病变残存的患者进行了立体定向放射治疗 (X -刀 )。按 1992年福州会议分期 ,Ⅰ期 0 % ,Ⅱ期 10 5 % ,Ⅲ期 6 9 2 % ,Ⅳ期 2 0 3 % ,外照射鼻咽部DT6 80 0～ 70 0 0cGY/ 7～ 8周。Ⅲ ,Ⅳ期病例 (89 5 % )加用化疗PVF或POF方案 2～ 4周期。X—刀治疗患者的选择为经足量外照射后 2～ 4周鼻咽部及咽旁间隙仍有肿瘤残存的或治疗半年后发现鼻咽部复发的各期患者。采用西门子MD 77直线加速器及深圳柯瑞特XST -SYSX线立体定向治疗系统进行治疗。一般 6 0 0～ 80 0cGY/次 ,共 3次 ,间隔 7天。结果 1年生存率为 10 0 % ,3年生存率为 94%。生存质量评定KPS评分无明显下降。肿瘤总控制率 88% (4 4/ 5 0 ) ,其中完全消失 46 % (2 3/ 5 0 ) ,明显缩小 2 6 % (13/ 5 0 ) ,缩小 16 % (8/ 5 0 )。结论鼻咽癌的分次性立体定向放射治疗是采用高精度、高剂量的治疗方式作为一个“挽救性治疗”的手段 ,是治疗鼻咽癌放疗后残存或肿瘤复发的有效方法之一。更多还原

【Abstract】 Objective To investigate the clinical application of the physiological permanent cardiac pacing.Methods 21 patients (14 males and 7 females) with age between 42 to 81 years, 10 with sick sinus syndrome, 9 with advanced atrioventricular block, 2 with trifascicular block, were implanted by DDDR (8 cases ) , DDD (10 cases ), AAI (1 case ) and VVIR (2 cases ) respectively. Results All implanted physiological cardiac pacemakers accounted for 50 percent of the total implanted pacemakers, dual chamber pacemakers for 42.9% and rate-adaptive pacemakers for 23.8%. The atrial and /or ventricular electrodes were implanted in right atrial appendage or right ventricular apex through the subclavian vein. The pacing threshold, electrode impedance and P or R wave amplitude was measured satisfactorily. Conclusion Physiological permanent cardiac pacing was an ideal pacing mode更多还原