立体定向放射治疗肝转移癌临床疗效观察

目的 观察采用立体定向放射治疗多发肝转移癌的临床疗效和不良反应.方法 28例肝转移癌患者行立体定向放射治疗.28例中,男18例,女10例,年龄22～78岁,中位年龄51岁.根据肿瘤的位置、靶体积(GTV)、患者的肝功状况与治疗目的制订放射治疗计划及调整剂量分布.采用单靶点或多靶点融合治疗,使55%～80%的等剂量曲线包绕95%的肿瘤靶体积(GTV),周边照射剂量32～42Gy,中位剂量40Gy,分割处方剂量320～450cGy,分次治疗8～12次,1次/d,每周连续治疗5次.结果 完全缓解15例(54%),部分缓解6例(21%),稳定4例(14%),进展3例(11%).有效率为75%,肿瘤局部控制率为80%.中位生存期15个月,1、2、3年生存率分别为66%、32%、11%.全组病例无严重并发症,上腹部不适、食欲不振21例,治疗后有18例(86%)改善;肝区疼痛6例,5例治疗后疼痛有不同程度的缓解,有效率为83.3%.结论 立体定向放射治疗对肝转移癌是安全有效的方法之一,无严重治疗并发症发生.

Application of stereotactic conformal radiotherapy for patients with liver metastases cancer

Objective To investigate the result and complication of liver metastatic tumor treated with stereotactic conformal ra- diotherapy.Methods Twenty-eight cases with liver metastases cancer were treated by the application of technique of stereotactic conformal radiotherapy.Among these 28 patients.18 were male and 10 female,with ages ranging from 22 to 78 years(median 51 years).Planning of treatment was made and the prescribed dose was adjusted depending on the site of the tumor,gross target vol- ume(GTV),liver function and aim of treatment.Targets were treated in patients using one or multiple center and 55%-80% iso- dose curve.The ranging of prescribed dose was 32-42Gy by fraction from eight to twelve times treated with five fractions one week.Results Of the 28 cases,complete response was observed in 15(54%),and partial response in 6(21%),stable disease in 4 (14%),and progressive disease in 3(11%).The effective rate was 75%.The overall local control rate was 80%.The mean surviv- al time was 15 months.The 1-,2-,and 3-year survival rate was 66%,32% and 11%,respectively.No serious complication was ob- served in the whole groups.No serious complication was found during radiotherapy and follow up.Conclusion Stereotactic confor- mal radiotherapy is safe and effective for liver metastatic tumor.No serious complication was observed during the treatment.