全身γ刀治疗原发性肝癌的疗效分析

目的探讨全身γ刀治疗原发性肝癌的疗效。方法 139例患者采用OUR-QGD型立体定向γ射线全身治疗系统（全身γ刀）治疗原发性肝癌,50%剂量线覆盖计划靶体积100%,处方剂量3～5Gy/次,隔日1次,总照射剂量36～50Gy。结果完全缓解率（CR）20.9%,部分缓解率（PR）48.9%,无变化（NC）15.8%,进展（PD）14.4%,总有效率为69.8%。1,2,3年总生存率分别为81.3%、62.5%和45.8%,Ⅲ期1,2年总生存率为52%和30.7%,Ⅳ期1,2年总生存率为31.3%和18.8%。结论全身γ刀治疗原发性肝癌安全有效,对早期及Ⅲ期肝癌可提高局控率和生存率,对部分晚期患者,可缓解症状,提高生活质量。

Analysis of efficacy of body gamma knife in treatment of primary hepatocelluar carcinoma

Objective To investigate the efficacy of body gamma knife in the treatment of primary hepatocellular carcinoma.Methods 139 patients with primary hepatocellular carcinoma were treated with OUR-QGD body gamma knife.The isodose curve was prescribed to the 50%,which covered about 100% of the target volume.The fractional dose was given 3-5 Gy per fraction,one fraction every other day.The total dose was 36-50 Gy.Results Three months after the treatment,the tumor response rate was CR 20.9%,PR 48.9%,NC 15.8%,PD 14.4%.The overall response rate（CR ＋ PR）was 69.8%.The 1-,2-and 3-year survival rates were 81.3%,62.5% and 45.8%,respectively.For patients with stage Ⅲ,the 1-and 2-year survival rates were 52.0% and 30.7%.For patients with stage Ⅳ,the 1-and 2-year survival rates were 31.3% and 18.8%.Conclusion Body gamma knife can safely and effectively control the progression of hepatic carcinoma for patients earlier than stage Ⅲ.For late stage patients,body gamma knife can relieve their symptoms and improve their life quality.