超级伽玛刀治疗晚期肾肿瘤的临床疗效分析

Clinical efficacy of super gamma system therapy for advanced kidney cancer

目的:探讨超级伽玛刀立体定向放射治疗晚期肾肿瘤的近期疗效。方法:对有病理组织学证实的18例III-IV期肾肿瘤患者(年龄25岁-84岁),应用立体定向放射治疗(SRT)技术治疗,观察其毒副作用和近期疗效。计划治疗3-8枪点,单次剂量3Gy-5Gy,2-5次/WK,照射总量30Gy-40Gy。治疗计划中≥50%的等剂量曲线包饶计划靶区(PTV),平均肾脏剂量均小于15Gy。结果:6月后复查18例肾肿瘤患者全部生存,完全缓解(CR,肿瘤完全消失)3例(16.7%),部分缓解(PR,肿瘤缩小50%以上)9例(50.0%),无变化(NC,肿瘤缩小不及50%或增大未超过25%)3例(16.7%),进展(PD,病变增大25%以上或出现新的病灶)3例(16.7%),肾转移瘤有效率100%(4/4),≤5cm的肿块的有效率为100%(6/6),>5cm的肿块有效率为50.0%(6/12),总有效率66.7%。结论:超级伽玛刀技术可靠、安全,对于晚期肾肿瘤患者有助于提高局部区域性控制,进而提高病人的生存率。

Objective：To investigate the curative effect of super - gamma - knife treating tumor of kidney at the advanced stage. Methods： Eighteen patients at III- IV stage tumor of kidney （25 - 84 Y） were treated with stereotaxis radiation therapy （SRT） of super- gamma- knife. Treatment planning was 3 to 8 dots,3Gy- 5Gy per- fraction,2 -5times per week, and the total treatment doses was 30Gy -40Gy. ≥50% isodose covered planning target volume（PTV）. Average dose on kidney was less than 15Gy. Results： In 18 patients the 6 - moths survival rate was 100% （ 18/18 ）. The complete response （CR） rate , partial response （PR） rate , no change （ NC ） rate and progression disease （PD） rate were 16.7 % , 50.0 % , 16.7% and 16.7% ,respectively. Effective power of kidney meta- static tumor, of ≤5cm tumor, of 〉5cm tumor were 100% （4/4） ,100% （6/6） ,50.0% （6/12）, respectively. Total effective rate was 66.7%. Conclusion： Technique of super gamma knife can effectively and safely control the progression of tumor of kidney and promote the survival rate.