体部伽玛刀治疗门静脉主干癌栓疗效观察

Observation of clinical therapeutic effectiveness of body gamma knife in treating the main portal vein tumor thrombus in hepatocellular carcinoma

目的：探讨体部伽玛刀治疗原发性肝癌伴门静脉癌栓（PVTT）的疗效。方法：对52例原发性肝癌伴门静脉癌栓患者实行伽玛刀治疗。采用50％～700／0等剂量曲线覆盖计划靶区（PTV），单次处方剂量为3．0～4．5Gy，照射总剂量在30～49．5Gy之间，并观察PVTT近期疗效及生存率。结果：伽玛刀治疗结束3个月后，门静脉癌栓完全缓解18例（占34．62％），部分缓解23例（占44．23％），稳定4例（占7．69％），进展7例（占13．46％），总有效率为78．85％。生存6个月48例（占92．31％），生存12个月38例（占73．08％），24个月29例（占55．77％），中位生存期为14．04-月。结论：伽玛刀治疗门静脉癌栓疗效确切，能够延长患者的生存期。

Objective： To investigate the clinical therapeutic etlectiveness ot body gamma knife in treating the portal vein tumor thrombus （PVTT） in patients with primary hepatocellular carcinoma. Methods： From August 2006 to June 2010, the total of 52 patients with PVTT of unresectable hepatocellular carcinoma were treated by body gamma knife. The planned targetvolume （PTV） was encompassed by 50%-70% isodose line. The single therapeutic dose was 3.0Gy to 4.SGy, and total dose was from 30Gy to 49.5Gy. To observe the term efficacy andsurvival, al rate o（PVTT. Results： 3months after treatment, CR was 18 cases （34.62%）, PRwas 25 cases （44.23%）, and the effective power （CR＋PR） of PVTT was 78.85%. 6, 12, 24-month survival rate was 92.51%, 75.08% and 55.77%. The median survival time was 14.0 months. Conclusion： Body gamma knife is an effective method in the treatment of portal vein tumor thrombus in hepatocellular carcinoma, andcan extend the survival time.