体部伽玛刀治疗原发性大肝癌163例疗效分析

Clinical analysis of whole body γ-knife radiotherapy for 163 cases with large primary liver cancer

目的:探讨全身γ刀立体定向放射治疗原发性大肝癌的临床可行性及疗效。方法:采用超级γ刀(SGS-I型)立体定向放射治疗原发性大肝癌163例,根据肿瘤的位置、临床靶体积、病人的身体状况与治疗目的,制定放射治疗计划及调整剂量分布。肿瘤体积56.9-2697.0cm3,等剂量曲线50%-60%,周边照射总剂量33-40Gy,分割处方剂量3.3-5.0Gy,重复治疗8-12次,5次/周。结果:治疗前肝区胀痛不适等98例,治疗结束后1-3个月,症状完全消失59例(60.20%),部分缓解30例(30.61%),9例无效(9.18%),症状改善有效率为90.82%;163例病人治疗后2-3个月复查CT或MR,肿瘤CR 17例(10.43%),PR 79例(48.47%),NC57例(34.97%),PD 10例(6.13%),总有效率93.87%。6个月和1年生存率分别为71.17%和58.90%。结论:全身γ刀立体定向放射治疗原发性大肝癌临床效果确切,副反应较轻。

Objective：To investigate the clinical application and the short-term effect of stereotactic radiotherapy with whole body γ-knife in patients with large primary liver cancer.Methods： From March 2007 to May 2008,163 patients with large primary liver cancer were treated using stereotactic radiotherapy with Super-Gamma-Knife.The total radiation dose was 33-40Gy,3.3-5.0Gy/f（50%-60% isodose line）,one fraction /d,five days/w.The effect and side effect of stereotactic radiotherapy were analyzed.Results： In 163 patients,CR was 10.43%,PR was 48.47%,NC was 34.97%,and PD was 6.13%.The overall response rate was 93.87% three months after treatment;The 6-month and 1-year survival rates were 71.17% and 58.90% respectively.Serious complications of radiotherapy were not seen.Conclusion： The clinical results of stereotactic radiotherapy with super-gamma-knife for large primary liver cancer are definitive and safe with mild side effect.