立体三维适形放射治疗肝癌65例分析

目的:探讨应用立体三维适形放射治疗肝癌的近期疗效和副反应.方法:肝癌65例设置靶区81个,其中原发性肝癌43例,转移性肝癌22例,采用三维适形放疗技术(3D-CRT)治疗,每个病灶靶区设野5～7个,每日照射1次,每次治疗剂量2.3～2.8 Gy,90%等剂量曲线包绕靶区,同时应用保肝药及免疫增强剂.结果:治疗后1～4 mo内根据CT或MRI及B超复查肿瘤退缩情况,确定为完全缓解率(CR)18个病灶靶区18/81(22.2%),部分缓解率(PR)52个52/81(64.1%),无变化(NC)7个7/81(8.6%),加重(PD)4个4/81(4.9%),总有效率为(CR PR)达86.3%.结论:立体三维适形放射治疗肝癌安全,副作用小且近期疗效确切的治疗方法,能使大多数患者尤其老年患者所耐受.

Three-dimensional conformal radiotherapy for 65 patients with hepatocellular carcinoma

AIM: To assess the value and side-effect of three-dimensional conformal radiotherapy for primary and metastatic hepatocellular carcinoma (HCC). METHODS: Eighty-one target regions in 65 patients with HCC underwent three-dimensional conformal radiotherapy (3D-CRT) in a dose range of 48 to 55 Gy in 5 to 7 fractions for 20 to 24 d. The total clinical tumor volume (CTV) received more than 90% of the prescribed irradiation dose delivered from 6 MV X-ray. All the patients were treated with the liver protectants and immunopotentiating agents. RESULTS: CT, MRI or B-mode ultrasonography examinations were performed in a 1- to 4-month follow-up period to verify the therapeutic effects. Complete response (CR) was achieved in 18 target regions (22.2%), partial response (PR) in 52 target regions (64.1%), no change (NC) in 7 target regions (8.6%) and progressive disease (PD) in 4 target regions (4.9%). Total effectiveness rate (CR+PR) reached 86.3%. CONCLUSION: 3D-CRT is an effective and safe method for treating HCC in the short term with low side effect, which can be tolerated by most senile patients.