体部伽玛刀治疗头颈部腺样囊性癌多发肺转移瘤临床观察

 目的　观察体部伽玛刀治疗头颈部腺样囊性癌多发肺转移瘤的临床疗效。方法　对15例头颈部腺样囊性癌肺转移瘤患者共计137个病灶采用立体定向体部伽玛刀治疗。单次治疗病灶2～10灶，中位数5灶。以50 %剂量线为处方剂量线，单次照射剂量3～5 Gy，中位数4 Gy，1次／ d，5次／周，10～16次。肿瘤边缘总剂量30～52 Gy，中位数40 Gy。结果　137个病灶中，完全缓解58灶（42.3 %），部分缓解64灶（46.7 %），稳定15灶（10.9 %），进展0灶，总有效率为89.1 %。治疗后1、2、3年局控率均为100.0 %。治疗后1、2、3、4、5年生存率分别为100.0 %、100.0 %、90.9 %、63.6 %、31.8 %。结论　体部伽玛刀治疗头颈部腺样囊腺癌多发肺转移瘤疗效较好，反应轻微，是一种安全有效的治疗手段。

Clinical study of stereotactic gamma-ray body radiation therapy for patients with pulmonary metastases derived from adenoid cystic carcinoma of the head and neck

Ｏbjective　To evaluate the value of the stereotactic gamma-ray body radiation therapy for patients with pulmonary metastases derived from adenoid cystic carcinoma of the head and neck. Methods　15 patients with 137 lung metastases treated with stereotactic gamma-ray body radiation therapy were analyzed. The patients experienced one to five courses of stereotactic gamma-ray body radiation therapy. 2 to 10 lesions were radiated in one treatment and the median number is 5. The daily radiation dose of 50 % isodose line covering metastatic lesions was from 3-5 Gy and 5 fractions per week. 30-52 Gy total doses in the edge of 50 % isodose line were divided into 10-16 times. Results　58 (42.34 %) lesions completely disappeared, 64 (46.72 %) lesions were assessed into partial responses, 15 (10.94 %) stable disease and 0 progression disease. The total effective rate was 89.06 %. Local control rates of 1, 3 and 5-year were all 100 %. The overall survival rates of 1 year, 2-year, 3-year, 4-year and 5-year were 100 %, 100 %, 90.9 %, 63.6 % and 31.8 %, respectively. Conclusion　The stereotactic gamma-ray body radiation therapy is an effective and safe method in treatment with lung metastases from primary adenoid cystic adenocarcinoma of head and neck.