伽玛刀治疗肝胆恶性肿瘤的临床研究

Clinical studies on GAMMA Knife for treatment of hepatobiliary neoplasm

目的探讨伽玛刀治疗肝胆恶性肿瘤的临床疗效及相关影响因素。方法回顾性分析30例经伽玛刀治疗的肝胆恶性肿瘤患者共48个结节,分析其局部控制率,生存率及其相关影响因素。结果短期局部有效控制率为75%(6个月显效和有效患者)。在所有有效控制的结节中,直径≤5cm为85.71%,>5cm为60.00%,两者差异有统计学意义(P<0.05),而肿瘤的性质也是影响局部有效控制率的因素,原发性肝癌75%,继发性肝癌91.00%,胆管癌33.33%(P<0.05)。伽玛刀术后6、12个月的生存率分别为83.33%,45.83%。生存率与患者的性别,年龄,肿瘤的大小,数目没有明显的关系,而患者的肝功能,肿瘤的性质是影响术后生存率的主要因素。结论行立体定向射线全身治疗系统治疗中晚期肝癌对控制肿瘤局部生长和提高短期生存率有一定的疗效,但治疗胆管癌的疗效差。

Objective To evaluate the clinical efficiency and the relationship factor. Methods To investigate the effect and its factors on GAMMA knife for the treatment of the hepatobiliary tumor through analyzing the 30 cases with 48 nodes. Results local control rate was 75 %, it was significantly higher in the tumor ≤〈 5cm （ 85.71 ） in diameter than 〉 5cm （ 60 % ） （ P 〈 0.05 ）, and in liver carcinoma （primary：75 % ,secondary：91% ）than in bile duct neoplasm（33.33% ） （ P 〈 0.05） .the 6-month and 1-year survival rate was 83.33% and 45.83 %, the relationship factor was liver function and kind of neoplasm. Conclusion Gamma knife is a effective method for liver neoplasm patients in aspect of controlling local focus and enhancing survival rate but the effect in treating bile duct cancer is poor and with severe side-effect.