射波刀治疗原发性肝癌合并梗阻性黄疸11例疗效观察

Curative effect observation of 11 cases of primary liver cancer with obstructive jaundice treated by cyberknife

目的评价立体定向放射治疗技术(射波刀)治疗肝癌合并梗阻性黄疸的疗效和不良反应。方法对11例肝癌合并梗阻性黄疸的患者行射波刀治疗。单次分割剂量5~7 Gy,照射次数为7~10次,肿瘤计划靶区剂量48~50 Gy,连续照射。其中2例TBIL>300μmol/L的患者在放疗前联合经皮肝穿刺胆道引流术或经内镜逆行性胰胆管造影术进行治疗。结果随访12~28个月,治疗结束后12个月患者肿瘤局控率为81.8%,临床获益率为81.8%,12个月生存率为81.8%,且TBIL、ALT、ALP、谷氨酰转肽酶等相关临床指标明显改善。结论射波刀治疗肝癌合并梗阻性黄疸,肿瘤局控率高,胆红素明显下降,疗效确切,不良反应小。

Objective To evaluate the efficacy and adverse effects of stereotactic radiotherapy（cyberknife） in the treatment of primary liver cancer patients with obstructive jaundice. Methods Cyberknife for 11 cases of primary liver cancer patients with obstructive jaundice were conducted. A total of 48~50 Gy was continuously delivered to planning target volume with single dose of 5 ~ 7 Gy and 7 to 10 fractions. The combined treatment of percutaneous transhepatic cholangio-drainage or endoscopic retrograde cholangiopancreatography was conducted for two patients with TBIL 〉 300 μmol/L before radiotheraphy. Results These patients were followed up for 12 to 28 months after cyberknife treatment. Twelve months after the treatment, the tumor control rate was 81.8%, and clinical benefit rate was 81.8%. The survival rate was 81.8%. The related clinical indicators such as TBIL, ALT, ALP, GGT were significantly improved. Conclusions The treatment of liver cancer with obstructive jaundice by cyberknife has a high tumor control rate with significant decrease of serum bilirubin, exact curative effect and small adverse reaction.