X线立体定向放射治疗前列腺癌的临床应用

Clinical application of stereotactic radiotherapy for prostate cancer

目的 探讨X线立体定向放射治疗（X线刀）前列腺癌的适应证、禁忌证和近期疗效。方法 采用X线刀对16例前列腺癌患者进行了立体定向放射治疗。肿瘤中心刘量为6～8Gy／次，肿瘤边缘剂量在80％～90％的剂量曲线范围内，隔日1次，共5～7次。结果 16例患者经X线刀治疗后3、6、12个月复查有效率分别为75％（12／16）、100％（16／16）和93．75％（15／16）；6个月时病灶缩小最明显，12个月以后出现1例病灶再增大。中位生存期51．4个月，1、3、5年生存率分别为100％（16／16）、87．5％（14／16）、75．0％（12／16）。结论 立体定向放射治疗中晚期前列腺癌有较好的效果，不良反应小，可作为前列腺癌姑息治疗的有效选择之一。

Objective To study the indication, contraindication and clinical results of stereotactic radiotherapy （X-knife） for prostate cancer. Methods Sixteen cases of prostate cancer were treated by X knife. Sixteen cases were received 6-SGy per fractoin, with peripheral clips were covered in 80% and 90% ,and once every two days,5-7 fractions. Results The 3-month,6-month,and 12-month local control rates of 16 cases after X-knife treatment were 75 % （ 12/16）, 100 % （16/16） and 93.75% （15/16） respectively. The best result in 6 months after treatment and focus recurrence appeared in 12 months after treatment. The middle time of survival period was 51.4 months. The 1-year,3-year and 5-year survival rates of 16 cases treatment with X-knife were 100% （16/16）, 87.5%（14/16）and 75.0%（12/16）respectively. Conclusion The stereotactic radiotherapy can be used in practice for prostate cancer. There are better effect and lesser side-effect with the method. It can be used as good selection of treatment for advanced prostate cancer.