射波刀SBRT治疗肝门区肝癌临床疗效观察

Clinical efficacy of CyberKnife stereotactic body radiation therapy for hepatic hilar cancer

目的 评价射波刀在肝门区肿瘤治疗中的疗效及安全性。方法 回顾分析2009—2015年间天津医科大学肿瘤医院收治的接受射波刀SBRT的 36例肝门区肝癌患者的病历资料。36例患者（37个病灶）的肿瘤直径为 15-55 mm （中位数30 mm）,其中 20例患者（21个病灶）采用金标呼吸同步追踪技术,16例患者（16个病灶）采用椎体追踪技术。通过增强CT和（或） MRI评价肿瘤进展,Kaplan-Meier法计算LC、OS并Logrank检验和单因素分析。结果 中位随访时间为12.7个月。术后1、2年LC率分别为90%、76%,术后 1年OS、PFS分别为63%、39%,中位OS、PFS时间分别为15.2、10.0个月。3级不良反应为11%。结论 射波刀SBRT是肝门区肝癌的一种安全有效的治疗方式。

Objective To evaluate the efficacy and safety of CyberKnife stereotactic body radiation therapy （SBRT） in the treatment of hepatic hilar cancer. Methods A retrospective study was performed on the clinical data of 36 patients with hepatic hilar cancer who were admitted to our hospital and treated with CyberKnife SBRT from 2009 to 2015. In the 36 patients, 37 lesions were found with tumor diameters ranging from 1.5 to 5.5 mm （median diameter 3 cm）. The Synchrony respiratory tracking system was used for 21 lesions in 20 patients, while the XSight spinal tracking system was used for 16 lesions in 16 patients. Local progression was evaluated based on contrast-enhanced computed tomography and/or magnetic resonance imaging. The Kaplan-Meier method was used to calculate local control （LC） and overall survival （OS） rates, and the log-rank test was used for survival comparison and univariate prognostic analysis. Results The median follow-up time was 12.7 months. The 1-and 2-year postoperative LC rates were 90% and 76%, respectively. The 1-year OS and progression-free survival （PFS） rates were 63% and 39%, respectively. The median OS and PFS times were 15.2 and 10 months, respectively. The incidence of grade 3 adverse reactions was 11%. Conclusions The CyberKnife SBRT is a safe and effective way to treat hepatic hilar cancer.