|
|
| 锟斤拷模式锟斤拷锟斤拷直锟斤拷锟斤拷锟斤拷锟斤拷植锟斤拷锟斤拷锟� |
|
直锟斤拷锟斤拷锟斤拷锟斤拷植锟斤拷锟斤拷锟轿ｏ拷盏慕锟斤拷锟皆达拷锟斤拷锟角帮拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷稀锟�
锟斤拷锟斤拷植锟斤拷锟斤拷锟斤拷锟街憋拷锟斤拷锟斤拷锟斤拷锟绞э拷艿锟斤拷锟斤拷锟揭拷锟斤拷锟皆斤拷锟皆斤拷锟斤拷锟斤拷酆锟斤拷锟斤拷频慕锟斤拷欤拷碌锟斤拷酆锟斤拷锟斤拷锟侥Ｊ斤拷芊窠档锟街憋拷锟斤拷锟斤拷木植锟斤拷锟斤拷锟轿ｏ拷眨锟斤拷佣锟斤拷锟斤拷锟斤拷锟皆わ拷锟�
锟斤拷英锟斤拷医学锟叫撅拷锟斤拷锟铰会（MRC锟斤拷锟酵硷拷锟矫达拷锟斤拷锟斤拷锟街拷芯锟斤拷锟斤拷锟絅CIC锟斤拷锟斤拷锟斤拷锟斤拷MRC CR07/NCIC-CTG C016锟叫撅拷锟斤拷CR07/C016锟叫撅拷锟斤拷锟斤拷锟斤拷锟剿答案ｏ拷锟斤拷选锟斤拷锟斤拷锟斤拷锟斤拷呕锟斤拷锟斤拷锟饺ｏ拷为锟斤拷5锟斤拷锟斤拷锟角帮拷锟斤拷锟绞癸拷锟斤拷锟斤拷锟街憋拷锟斤拷锟斤拷锟斤拷叩锟�3锟斤拷植锟斤拷锟斤拷锟轿ｏ拷战锟斤拷锟�61%锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟芥范锟斤拷锟侥革拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟狡成癸拷锟侥憋拷证锟斤拷锟斤拷篇锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟�3锟斤拷7锟秸的★拷锟斤拷叶锟斤拷锟斤拷锟斤拷The Lancet锟斤拷锟斤拷志[Lancet 2009, 373(9666): 811; 821]锟斤拷
CR07/C016 锟叫撅拷
CR07/C016 锟叫撅拷锟斤拷4锟斤拷锟斤拷锟揭碉拷80锟斤拷医学锟斤拷锟侥斤拷锟叫ｏ拷锟斤拷锟斤拷锟斤拷锟�1350锟斤拷锟斤拷锟斤拷锟斤拷直锟斤拷锟劫帮拷锟斤拷锟竭憋拷锟斤拷锟斤拷锟斤拷椋�674锟斤拷锟斤拷锟斤拷为锟斤拷5锟斤拷亩坛锟斤拷锟角帮拷锟斤拷疲锟�25 Gy/5 f锟斤拷锟斤拷676锟斤拷锟斤拷直锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷选锟斤拷锟斤拷锟斤拷锟斤拷呕锟斤拷疲锟�45 Gy/25 f+5-锟斤拷锟斤拷锟斤拷啶ｏ拷锟斤拷锟斤拷锟节伙拷锟斤拷锟斤拷缘锟斤拷锟斤拷锟竭ｏ拷锟斤拷
锟叫撅拷锟皆局诧拷锟斤拷锟斤拷锟斤拷为锟斤拷要锟秸点，锟斤拷要锟秸碉拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷屎锟斤拷薏锟斤拷锟斤拷锟斤拷省锟�
锟斤拷锟斤拷锟斤拷锟斤拷时锟斤拷锟斤拷锟斤拷330锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷前锟斤拷锟斤拷锟斤拷锟窖★拷锟斤拷锟斤拷锟斤拷锟脚伙拷锟斤拷锟斤拷锟�157锟斤拷锟斤拷173锟斤拷锟斤拷锟斤拷锟斤拷锟芥患锟斤拷锟斤拷位锟斤拷锟斤拷锟�4锟疥，99锟斤拷锟斤拷锟竭局诧拷锟斤拷锟斤拷锟斤拷锟斤拷前锟斤拷锟斤拷锟斤拷锟窖★拷锟斤拷锟斤拷锟斤拷锟脚伙拷锟斤拷锟斤拷直锟轿�27锟斤拷锟斤拷72锟斤拷锟斤拷
直锟斤拷全系膜锟叫筹拷锟斤拷锟叫筹拷锟斤拷围示锟斤拷图
锟斤拷锟斤拷图为矢状位锟斤拷小图为锟斤拷状位锟斤拷锟斤拷色锟斤拷锟斤拷圈为锟叫筹拷锟竭界）
CR07/C016锟叫撅拷锟侥伙拷锟斤拷锟�
锟今：肯讹拷
· 锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷要
· 锟斤拷前锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟�
· 锟教筹拷锟斤拷前锟斤拷锟狡ｏ拷25 Gy/5 f锟斤拷 锟斤拷全锟斤拷锟斤拷效
锟襟：诧拷锟斤拷
· 锟斤拷前锟斤拷锟狡的猴拷锟街凤拷锟斤拷锟斤拷眩锟斤拷坛谭锟斤拷疲锟斤拷锟斤拷浅锟斤拷锟街革拷呕锟斤拷疲锟斤拷锟斤拷锟窖★拷锟斤拷锟斤拷锟斤拷锟脚伙拷锟斤拷锟介方锟斤拷锟斤拷锟斤拷
· 锟街诧拷锟斤拷锟斤拷锟斤拷锟斤拷锟叫斤拷锟酵ｏ拷锟睫诧拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷撸锟斤拷锟斤拷锟斤拷锟斤拷锟轿拷锟矫伙拷锟斤拷锟竭ｏ拷
锟斤拷锟斤拷锟斤拷锟街伙拷锟斤拷坛锟斤拷锟角帮拷锟斤拷锟�
“锟斤拷前锟斤拷锟狡斤拷锟斤拷锟斤拷锟斤拷植锟斤拷锟斤拷锟轿ｏ拷锟�”锟斤拷锟斤拷锟窖撅拷锟斤拷锟斤拷一锟斤拷锟铰观碉拷锟剿ｏ拷锟斤拷前锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷芯锟斤拷贸锟斤拷锟斤拷锟斤拷频慕锟斤拷郏锟斤拷锟紺R07/C016 锟叫撅拷锟斤拷为锟斤拷锟结供锟斤拷锟铰碉拷锟桔据★拷
锟斤拷CR07/C016 锟叫撅拷锟叫ｏ拷锟斤拷前锟斤拷锟斤拷锟斤拷锟窖★拷锟斤拷锟斤拷锟斤拷锟脚伙拷锟斤拷锟斤拷锟�3锟斤拷植锟斤拷锟斤拷锟斤拷史直锟轿�4.4%锟斤拷10.6%锟斤拷锟斤拷锟斤拷木锟斤拷圆锟街滴�6.2%锟斤拷锟斤拷前锟斤拷锟斤拷使锟街诧拷锟斤拷锟斤拷锟斤拷锟斤拷锟轿ｏ拷战锟斤拷锟斤拷锟�61%[锟斤拷锟秸比ｏ拷HR锟斤拷=0.39锟斤拷P<0.0001]锟斤拷
锟斤拷锟狡的ｏ拷锟斤拷锟斤拷锟�3锟斤拷锟睫诧拷锟斤拷锟斤拷锟绞撅拷锟皆诧拷值为6.0%锟斤拷77.5%锟斤拷71.5%锟斤拷锟斤拷锟斤拷前锟斤拷锟斤拷使锟睫诧拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟�24%锟斤拷HR=0.76锟斤拷P=0.013锟斤拷锟斤拷
锟洁反锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷圆锟斤拷欤℉R=0.91锟斤拷P=0.40锟斤拷锟斤拷
锟斤拷么锟斤拷锟角诧拷锟斤拷锟斤拷锟叫的伙拷锟竭讹拷应锟斤拷锟斤拷锟斤拷前锟斤拷锟斤拷锟截ｏ拷锟斤拷锟剿凤拷锟矫和斤拷锟节诧拷锟斤拷症锟斤拷锟斤拷要锟斤拷锟斤拷之锟解，锟斤拷锟矫诧拷锟斤拷锟角碉拷锟斤拷锟斤拷一锟斤拷锟斤拷锟斤拷锟角伙拷锟斤拷瓶傻锟斤拷锟斤拷怨锟斤拷锟斤拷斐ｏ拷锟斤拷锟绞э拷锟斤拷锟叫★拷锟斤拷锟斤拷锟斤拷远锟节诧拷锟斤拷症锟斤拷锟斤拷锟斤拷锟角帮拷锟斤拷频亩锟斤拷锟斤拷坪锟揭灿︼拷锟斤拷锟斤拷锟窖★拷锟�
锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷源殴锟斤拷锟斤拷锟斤拷MRI锟斤拷锟斤拷锟斤拷锟绞撅拷锌锟斤拷锟斤拷锟皆碉拷奂锟斤拷幕锟斤拷吒锟斤拷锟斤拷锟角帮拷锟斤拷疲锟揭诧拷锟斤拷私锟斤拷椋拷锟組RI锟斤拷锟斤拷锟斤拷锟斤拷为锟斤拷准锟斤拷锟斤拷锟斤拷T3锟斤拷N1锟侥诧拷锟斤拷锟斤拷锟斤拷前锟斤拷锟狡★拷然锟斤拷锟斤拷锟阶革拷锟斤拷锟窖★拷锟侥壳帮拷锟斤拷薅锟斤拷郏锟斤拷锟斤拷锟揭拷锟斤拷锟斤拷俅锟斤拷芯锟斤拷锟斤拷锟斤拷锟斤拷鸢浮锟斤拷锟斤拷慰锟斤拷锟斤拷锟紺R07/C016锟叫撅拷锟叫ｏ拷锟斤拷锟斤拷锟斤拷锟节诧拷锟斤拷锟矫伙拷锌锟斤拷锟斤拷锟皆碉拷奂锟斤拷幕锟斤拷锟揭诧拷锟街な碉拷锟斤拷锟角帮拷锟斤拷锟斤拷谢锟斤拷妗�
锟斤拷锟斤拷锟斤拷锟街拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟�
目前锟窖撅拷锟斤拷锟较ｏ拷锟杰凤拷实施锟斤拷锟斤拷锟斤拷直锟斤拷全系膜锟叫筹拷锟斤拷锟斤拷TME锟斤拷锟斤拷锟角斤拷锟斤拷直锟斤拷锟斤拷锟斤拷锟斤拷植锟斤拷锟斤拷锟轿ｏ拷盏墓丶锟斤拷锟�
锟斤拷CR07/C016锟叫撅拷锟叫ｏ拷锟斤拷锟斤拷锟斤拷然锟斤拷锟斤拷锟斤拷实施TME锟斤拷锟斤拷锟斤拷未锟斤拷锟斤拷锟截憋拷锟絋ME锟斤拷训锟斤拷也未锟斤拷锟斤拷TME水准锟斤拷锟斤拷锟斤拷
锟斤拷1156锟斤拷锟斤拷锟竭的凤拷锟斤拷锟斤拷示锟斤拷锟斤拷锟斤拷锟斤拷缘锟斤拷锟斤拷锟斤拷为11%锟斤拷128锟斤拷锟斤拷锟斤拷锟斤拷全锟斤拷TME锟斤拷准锟斤拷锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷604锟斤拷锟斤拷52%锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷系膜锟戒（锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷398锟斤拷锟斤拷34%锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷锟叫硷拷锟姐（锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷154锟斤拷锟斤拷13%锟斤拷锟斤拷
锟斤拷锟斤拷锟斤拷缘状态锟斤拷锟斤拷影锟斤拷植锟斤拷锟斤拷锟轿ｏ拷铡锟斤拷锟皆碉拷锟斤拷浴锟斤拷锟斤拷锟斤拷叩锟�3锟斤拷植锟斤拷锟斤拷锟斤拷史直锟轿�6%锟斤拷17%锟斤拷锟斤拷锟秸比ｏ拷HR锟斤拷为0.32锟斤拷P=0.0011锟斤拷锟斤拷
锟角凤拷锟絋ME锟斤拷准也锟斤拷锟斤拷影锟斤拷植锟斤拷锟斤拷锟轿ｏ拷铡锟斤拷锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷龋锟斤拷摺锟斤拷锟斤拷锟斤拷锟斤拷谐锟斤拷叩锟�3锟斤拷植锟斤拷锟斤拷锟紿R锟街憋拷为0.32锟斤拷0.48锟斤拷锟竭★拷锟叫★拷锟斤拷锟斤拷锟斤拷锟叫筹拷锟竭碉拷3锟斤拷植锟斤拷锟斤拷锟斤拷史直锟轿�4%锟斤拷7%锟斤拷13%锟斤拷锟斤拷锟斤拷锟叫筹拷锟斤拷锟斤拷锟斤拷危锟斤拷锟斤拷呔锟斤拷艽佣坛锟斤拷锟角帮拷锟斤拷锟斤拷谢锟斤拷妫拷一锟斤拷锟教讹拷锟洁当锟斤拷锟斤拷锟斤拷锟斤拷前锟斤拷锟斤拷使锟斤拷锟介患锟竭的局诧拷锟斤拷锟斤拷锟绞讹拷锟斤拷锟斤拷锟斤拷约50%锟斤拷P=0.30锟斤拷锟斤拷
锟斤拷值锟斤拷一锟斤拷锟斤拷牵锟斤拷芯锟斤拷锟阶拷锟斤拷锟斤拷锟斤拷为锟饺斤拷锟斤拷锟斤拷前锟斤拷锟狡ｏ拷锟劫硷拷之锟皆革拷锟斤拷锟斤拷锟叫筹拷锟竭ｏ拷锟斤拷锟洁患锟竭碉拷3锟斤拷植锟斤拷锟斤拷锟斤拷式锟轿�1%锟斤拷
锟斤拷锟斤拷水平锟斤拷危锟街憋拷锟接帮拷斓街憋拷锟斤拷锟斤拷锟皆わ拷螅锟斤拷诒锟街わ拷锟斤拷锟斤拷锟斤拷谐锟斤拷幕锟斤拷锟斤拷锟斤拷锟斤拷锟斤拷锟角帮拷锟斤拷疲锟斤拷锟轿�“强强锟斤拷锟斤拷”锟斤拷锟斤拷锟斤拷危锟秸革拷锟酵★拷锟斤拷锟斤拷源锟斤拷锟叫癸拷医学锟斤拷坛锟斤拷 锟斤拷锟较ｏ拷
锟斤拷锟斤拷锟斤拷叶锟斤拷锟斤拷锟斤拷
The Lancet锟斤拷锟斤拷doi:10.1016/S0140-6736(09)60484-0锟斤拷David Sebag-Montefiore锟斤拷Mahesh Parmar锟斤拷
锟斤拷锟斤拷锟斤拷叶锟斤拷锟斤拷锟斤拷The Lancet锟斤拷锟斤拷doi:10.1016/S0140-6736(09)60485-2锟斤拷Phil Quirke锟斤拷David Sebag-Montefiore锟斤拷
锟斤拷锟斤拷锟侥讹拷锟斤拷英锟侥ｏ拷
