体部立体定向放疗治疗腹膜后转移瘤临床疗效观察

Clinical analysis of stereotactic body radiotherapy for retroperitoneal metastatic tumor

目的:观察全身γ刀立体定向放射治疗(SBRT)腹膜后转移瘤的近期疗效及不良反应。方法:采用超级γ刀(SGS-I型)立体定向放射治疗腹膜后转移癌65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8.7~1 352.3cm3,等剂量参考曲线50%~60%,周边照射总剂量40~48Gy,分割处方剂量4.0~6.0cG y,重复治疗8~10次,5次/周。结果:治疗前腰背部疼痛不适等40例,治疗结束后1至3个月,症状完全消失32例(80.0%),轻度缓解7例(17.5%),部分缓解1例(2.5%),症状改善有效率为97.5%。65例病人治疗后2~3个月复查CT或MR,肿瘤消失36例(55.38%),缩小27例(41.54%),无变化2例(3.08%),总有效率96.92%。2级放射性消化系统反应为16.18%,无>2级放射性消化系统反应的发生。结论:全身γ刀治疗腹膜后转移癌临床效果确切,毒副反应较轻。

Objective：To investigate the clinical application and the short-term effect of stereotactic radiotherapy with whole body γ-knife in the patients with retroperitoneal metastatic tumor.Methods：From January 2013 to December 2015,the data of 65 patients with retroperitoneal metastatic tumor were treated by stereotactic radiotherapy with super-gamma-knife,The total radiation dose was 40~48Gy,4.0~6.0Gy/f （50%~60% isodose line）,one fraction/d,five days/w.The effect and side effect of stereotactic radiotherapy were analyzed.Results：In 65 patients,the tumor disappeared in 36 cases （55.38%）,reduced in 27 cases （41.54%）,and unchanged in 2 cases （3.08%）with a response rate of 96.92% 2~3 months after treatment.Among 40 patients,pain in 32 cases of them was greatly alleviated,and pain was partially relieved in 7 patients with a response rate of 97.5% after treatment 1~3 months.Serious complications of radiotherapy were not seen.Conclusion：The clinical results of stereotactic radiotherapy with super-gamma-knife for retroperitoneal metastatic tumor are definitive and safe with mild side effect.