伽玛刀立体定向适形放射治疗胆管癌疗效分析

目的观察体部伽玛刀立体定向适形放射治疗胆管癌的近期疗效与不良反应。方法手术不能切除的胆管癌17例;胆管引流术后行立体定向适形放射治疗8例,单纯立体定向适形放射治疗9例。肿瘤PTV照射总量43.2~49.4Gy,10~14分次,13~17天完成。结果肿瘤灶完全缓解(CR)5例,部分缓解(PR)11例,总有效率(CR PR)为94.1%。放疗前行胆管引流术与单纯立体定向适形放射治疗的近期疗效间差异无显著意义(P>0.05)。患者黄疸指数下降,生活质量改善,KPS评分比治疗前平均增加27分;消化道反应和骨髓抑制等不良反应轻微。结论立体定向适形放射治疗胆管癌能有效的控制肿瘤,近期疗效满意,黄疸较重者放疗前辅以胆管引流术缓解症状快,但对肿瘤局部控制率无明显影响。

Analysis of the Effects of Stereotactic Conformal Radiotherapy for Bile Duct Cancer with Gamma-Knife

Objective To evaluate the early response and side-effect of stereotactic conformal radiotherapy for bile duct cancer. Methods From May 2001 to May 2004 ,8 cases from 17 patients with bile duct cancer were treated with stereotactic conformal radiotherapy after bile duct cholangio-jejunostomy, the others with stereotactic conformal radiotherapy alone. The method for radiotherapy was .0-.8Gy per fraction ,with a total dose of 4.2-49.4Gy in 10-14 frations over 1-17 days. Results 17 patients have achieved 5 CR ,11 PR,with a total response rate of 94.1%(16/17),all patients were improved in Karnofsky Performance Score. Conclusion Stereotactic conformal radiotherapy with Body Gamma-kinfe should be considered as an effective and feasible approach in the treatment of bile duct cancer. Long-term survival rate and possible specific injury will await further study.