立体定向放射治疗腹腔转移癌的临床分析

Clinical application of the stereotactic radiotherapy to metastatic abdominal cancer

目的 探讨立体定向放射治疗（X刀）腹腔转移癌的近期疗效和临床意义。方法 采用X刀对82例腹腔转移癌患者进行治疗。病灶最大直径≤3 cm者,4～6 Gy/次,隔日一次,6～8次;取肿瘤中心点剂量为100%,剂量归一,80%～90%的剂量曲线包绕病灶。病灶直径在3～5 cm者,3～4 Gy/次,隔日一次,8～10次;病灶最大直径≥5 cm者,2～3 Gy/次,隔日或每日一次,15～20次。结果 82例患者经X刀治疗后,3,6,12个月复查有效率（病灶消失和病灶缩小）分别为84.2%（69/82）、86.6%（71/82）和75.6%（62/82）;6个月时病灶缩小明显,12个月以后病灶出现再增大。82例患者的中位生存期为（14±1.2）个月。1,2,3年生存率分别为59.8%（49/82）、39.0%（32/82）和25.6%（21/82）。生存期长短与原发病变有关。结论 立体定向放射治疗腹腔转移癌有较好的效果,副作用小,可作为腹腔转移癌姑息治疗的有效选择之一。

Objective To study the clinical results and significance of stereotactie radiotherapy （ X- knife ） in treatment of metastatic abdominal cancer. Methods Eighty-two cases of metastatic abdominal cancer were treated whh X-knife . 4-6 Gy every other day was given for 6-8 fractions,when the tumour was 〈 3 cm,3-4 Gy for 8-10 fractions when the turnout was 3-5 cm and 2-3 Gy for 15-20 fractions when the tumor was 〉 5 cm,with 80%-90% of the dose encircling the lesion. Results The 3-,6-,and 12-month local con- trol rates of the 82 cases after X-knife treatment were 84.2% （69/82） , 86.6% （71/82） and 75.6% （62/ 82） respectively . The local recurrence appeared 12 months after treatment. The 1-year,2-year and 3-year survival rates were 59.8 % （49/82） ,39.0% （ 32/82 ） and 25.6% （ 21/82 ） , respectively. The median survival period was 14 ± 1. 2 months. The survival rate was related to the kind of primary tumour. Conclusions The stereotactic radiotherapy can be used for treatment of metastatic abdominal cancer, It has good efficacy and little side-effect and is a good choice for treatment of this cancer.