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目的 评价低剂量全身放疗对胸腺瘤术后重症肌无力患者的长期疗效。方法 ３０例非浸润型胸腺瘤术后重症肌无力病人随机分为两组，ＬＤ－ＴＢＩ加胸腺放疗１５例（ＬＤ－ＴＢＩ＋Ｔ），ＬＤ－ＴＢＩ １５例。放疗方案：（ＬＤ－ＴＢＩ＋Ｔ）组先行胸腺区放疗，再给予 ＬＤ－ＴＢＩ。 ＬＤ－ＴＢＩ采用 ８ ＭＶ－Ｘ线，ＳＳＤ ４．０５ ｍ，左右侧屈膝低头坐位照射，护眼及生殖腺，根据患者骨盆处横径，在中线处计算剂量。 １０ ｃＧｙ／次，２～３次／周，总量 １８０～２００ ｃＧｙ。胸腺区：超出肿瘤边缘 １～２ ｃｍ，前野照射，深度 ５～７ ｃｍ，ＤＴ ４０～４５ Ｇｙ／４～５周。放疗前后检测 ＡｃｈＲ－Ａｂ、免疫球蛋白。结果 ＬＤ－ＴＢＩ＋Ｔ组近期有效率９３．３％（１４／１５），远期有效率８０．０％（１２／１５），ＬＤ－ＴＢＩ组８６．７％（１３／１５），７３．３％（１１／１５），两组无显著性差异（Ｐ＞０．０５）。两组放疗后ＡｃｈＲ－Ａｈ滴度下降。免疫球蛋白（ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ_３补体）下降，放疗前后配对比较，有显著性差异Ｐ＜０．０５。ＬＤ－ＴＢＩ＋Ｔ组５年生存率８６．７％（１３／１５），ＬＤ－ＴＢＩ组５年生存率８０．０％（１２／１５）。结论 胸?
Objective To evaluate the long-term efficacy of low-dose systemic radiotherapy in patients with myasthenia gravis after thymoma surgery. Methods Thirty patients with myasthenia gravis after non-invasive thymoma surgery were randomly divided into two groups: LD-TBI plus thymus radiotherapy in 15 patients (LD-TBI+T) and LD-TBI in 15 patients. Radiotherapy program: (LD-TBI+T) group received radiotherapy in the thymus region before LD-TBI. LD-TBI uses 8 MV-X line, SSD 4.05 m, left and right knees to sit in the seat, eye protection and gonads, according to the diameter of the patient’s pelvis, calculate the dose at the midline. 10 cGy/time, 2 to 3 times/week, total 180 to 200 cGy. Thymus area: beyond the edge of the tumor 1 ~ 2 cm, front field irradiation, depth 5 ~ 7 cm, DT 40 ~ 45 Gy / 4 ~ 5 weeks. AchR-Ab and immunoglobulin were detected before and after radiotherapy. Results The effective rate was 93.3% (14/15) in the LD-TBI+T group, 80.0% (12/15) in the long-term and 86.7% (13/15) in the LD-TBI group, 73.3%. (11/15), there was no significant difference between the two groups (P>0.05). The titer of AchR-Ah decreased after radiotherapy in both groups. The immunoglobulins (IgG, IgA, IgM, C3 complement) decreased, and there was a significant difference P<0.05 before and after matched radiotherapy. The 5-year survival rate in the LD-TBI+T group was 86.7% (13/15), and the 5-year survival rate in the LD-TBI group was 80.0% (12/15). Conclusion Chest?