立体定向精确放疗治疗原发性肝癌伴肝外转移疗效观察

Clinical observation of stereotactic radiotherapy on patients with extrahepatic metastasis of primary hepatocellular carcinoma

目的:探讨立体定向放射治疗(stereotactic body radiation therapy,SBRT)对原发性肝癌合并肝外转移患者的治疗效果。方法:回顾性分析48例经立体定向精确放疗治疗的原发性肝癌伴肝外转移患者临床资料。通过改良版RECIST评价短期疗效。1年生存率、2年生存率及中位生存期评估患者长期疗效。数字疼痛强度分级法评估患者疼痛强度。急性放射损伤分级标准评价急性放疗不良反应。结果:短期疗效评估结果显示γ-SBRT治疗总有效率为82.1%;长期疗效评估显示治疗后患者1年生存率为52.1%(25/48),2年生存率为27.1%(13/48),中位生存期为13个月。疼痛评价显示γ-SBRT治疗后患者疼痛症状有不同程度的缓解,缓解率为83.3%。不良反应评价结果显示γ-SBRT治疗后,患者外周血白细胞计数下降,未出现明显骨髓抑制,无严重放射性肺炎发生。结论:γ-SBRT治疗可提高肝癌伴肝外转移患者生存率,严重不良反应发生率未明显增加。γ-SBRT治疗是肝癌伴肝外转移患者的一种有效治疗方式。

Objective：To investigate the effect of stereotactic body radiation therapy on primary hepatocellular careimoma patients with extrahepatic metastasis. Methods ： All 48 primary hepatoeellular carcinoma patients with extrahepatic metastasis were analyzed retrospectively. Response evaluation criteria in solid tumors was used to access short - term therapeutic efficacy. One -year survival rate, two -year survival rate and median survival time were used to access long - term therapeutic efficacy, NRS was used to aceesse the pain intensity of patients. ROTG acute radiation injury classification standard was used to access the acute reactions of radiation therapy. Results： The result of short - term therapeutic efficacy showed the total efficiency rate was 82.1% after a three - month treatment. The result of long - term therapeutic efficacy showed the median survival rate was 52.1% for one year and 27.1% for two years, the median survival duration was 13 months. The pain intensity of patients was reduced and the pain relief rate was 83.3% after radiation therapy. The number of white blood cells in patients was reduced after radiation therapy and there was no myelosuppression or radiation pneumonia in the patients. Conclusion：The stereotactic body radiation therapy can improve the overall survival of HCC patients with extrahepatic metastasis without evelating the incidences of adverse effect. It is safe and effective for HCC patients with extrahepatic metastasis.