伽玛刀治疗肝癌70例临床研究

目的探讨伽玛刀对肝癌治疗的临床疗效。方法将笔者所在肿瘤科2009年8月～2011年8月收治的140例肝癌患者,随机分为治疗组和对照组,每组各70例。治疗组患者先行碘油、顺铂、明胶海绵等经肝动脉化疗栓塞1～3次后再进行伽玛刀适形放疗。用50%～85%等剂量线包绕计划靶区,(350～450)cGy/次,5次/周,10～12次为1个疗程。对照组仅进行3次肝动脉化疗栓塞,方法同治疗组。结果治疗后治疗组3个月CR 32例,PR 20例,SD 14例,PD 4例,总有效率为74.3%。1、3、5年的累计生存率分别为92.9%、82.9%、70.0%。对照组CR 25例,PR 16例,SD 22例,PD 7例,总有效率为58.6%。1、3、5年的累计生存率分别为78.6%、45.7%、40.0%。两组结果比较,治疗组明显优于对照组,差异有统计学意义(P<0.05)。结论运用伽玛刀治疗肝癌,可准确高剂量照射肿瘤局部,又避免肿瘤周围正常组织遭受损害,且副作用少,对疾病有良好的治疗作用,值得在临床广泛推广应用。

Clinical study of treating 70 cases of liver cancer by Gamma knife

Objective To investigate the clinical efficacy of treating liver cancer by Gamma Knife. Methods Randomly di- vided 140 cases of the liver cancer patients in Oncology department admitted from August 2009 to August 2011 into treat- ment group and control group,70 cases in each group. In the treatment group,the patients treated with first lipiodol,cis- platin and gelatin sponge via the hepatic artery chemoembolization 1 to 3 times after gamma knife conformal radiotherapy. Surrounding the planning target volume with 50% to 85% measurement line,a single dose of of 350 to 450 cGy, 5 times a week, 10 to 12 times as a course of treatment. The control group only three times the hepatic artery ehemoembolization,the same way as the treatment group. Results After 3 months,CR 32 cases,PR 20 cases, SD 14 cases,PD 4 cases,the total ef- fective rate was 74.3%. The 1,3, and 5-year cumulative survival rates were 92.9%, 82.9%, 70.0%. In the observation group, CR 25 cases, PR 16 cases, SD 22 cases, PD 4 cases, the total effective rate was 58.6%. The 1,3,and 5-year cumulative survival rates were 78.6% ,45.7% ,40.0%. Compared the two sets of results, the treatment group was significantly better than the control group, the difference was statistically significant （P 〈 0.05）. Conclusion The use of gamma knife treatment of liver cancer can be accurate hi gh-dose irradiation, and the damage to the normal tissue around the tumor is a little, meanwhile with few side effects, and have a good treatment of the disease, which is worth be widely used in clinical .