射波刀治疗35例肝脏肿瘤的临床分析

目的：观察射波刀（cyberknife）治疗肝脏恶性肿瘤的疗效和安全性。方法：回顾性分析35例经射波刀治疗的肝脏恶性肿瘤患者，其中原发性肝癌12例，消化系统肿瘤肝转移16例，其他肿瘤肝转移7例。共57个病灶。所有患者行金标植入术，1周后行射波刀照射。平均肿瘤体积98.64ml，处方剂量18-51Gy，分割3-7次，等剂量线56%-85%。治疗后1-6个月复查，观察近期疗效，之后每3个月随访1次。结果：7例患者达到完全缓解，20例部分缓解，6例稳定，2例进展，有效率（CR＋PR）77.1%，局部控制率94.29%，中位TTP为12个月，中位生存期为23个月。所有患者耐受性良好，主要的不良反应为白细胞降低、食欲减退和疲劳。无Ⅳ级和Ⅳ级以上不良反应发生。结论：射波刀治疗肝脏恶性肿瘤有较高的有效率，安全性好，不良反应轻，患者易耐受。

Clinical analysis of 35 patients with liver tumor treated by cyberknife

Objective：To observe the efficacy and safety of cyberknife radiosurgery in patients with both primary or metastasis liver tumor. Methods：All 35 patients with liver tumor treated by cyberknife radiosurgery were included in this retrospective analysis,of which 12 were primary hepatic carcinoma,16 were hepatic metastases from gastrointesti-nal tract cancer and 7 from other sites,in totle 57 lesions. Fidicals were accurately placed to lable the lesions 7 days before radiotherapy with cyberknife. The mean gross tumor volume was 98. 64ml. A total dose of 18-51Gy with 2-7 fractions was prescribed to the 56% -85% isodose line of each patient. CT scans were performed 1-6 months after treatment to evaluate therapetic efficacy. The surveillance interval was every 3 months for 2 years. Results：Of 35 pa-tients,complete response（ CR）were achived in 7 patients,partial response（ PR）in 20 patients,stable disease（ SD） in 6 patients,and progressed disease（PD）in 2 patients. The response rate was 77. 1% and disease control rate was 94. 29%. The medial time to progress（TTS）was 12 months,and the medial overall survival（OS）was 23 months. All patients completed radiotherapy and no severe side effects（ gradeⅣ）were observed during treatment. Digestive disor-der and fatigue were most common side effects. Conclusion：Cyberknife is a safe and effective therapeutic method for liver tumor patients.