半肝交替三维立体定向适形放射治疗广泛转移性肝癌的近期疗效观察

目的探讨半肝交替三维立体定向适形放射治疗在肝脏广泛转移性肿瘤中的应用价值。方法用半肝交替三维立体定向适形放射技术治疗广泛转移性肝癌,优化指标:每次剂量2~3.5Gy,90%的等剂量曲线包绕PTV;平均肝脏剂量小于30Gy。半肝照射8~12次后换另半肝,3次/周。结果在放疗结束后2个月用腹部CT进行评价,有效率(CR PR)66.7%。1年局部无进展生存率72.7%。放疗中后无严重并发症发生。结论半肝交替三维立体定向适形放射治疗在不增加治疗并发症基础上,能明显提高肝广泛转移性癌的局部控制率。我们认为晚期病人出现广泛肝转移时,在其它部位病灶尚稳定的情况下可选择半肝交替三维立体定向适形放射治疗作为姑息治疗的有效选择之一。

Recent effect of semi - liver alternate and three - dimensional conformal radiotherapy for patient with liver widespread metastatic cancer

Objective To evaluate the application of semi-liver alternate and three-dimensional conformal radiotherapy on patients with liver widespread metastatic cancer.Methods We treated patients with liver widespread metastatic cancer by the application of technique of semi-liver alternate and three-dimensional conformal radiotherapy.The optimized index: planning target volume(ptv) received a minimun of 90% of the prescribed dose for 2~3.5Gy per fraction,the mean liver dose not reached 30 gy.8~12 fractions of each semi-liver,3 times once week.Results Patients would be evaluated by CT in two months after radiotherapy.The effective rate(CR PR) was 66.7%.1-year local recurrence-free survival rate was72.7%.There were no serious complications during radiotherapy and follow-up.Conclusion Semi-liver alternate and three-dimensional conformal radiotherapy can improve the local control on the treatment of liver widespread metastatic neoplasm and don't increase the treatment complication.When other site lesion of patients with liver widespread metastatic neoplasm is stable,we can use semi-liver alternate and three-demensional conformal radiotherapy to treat this kind of patient and take it as one of the effective option of appeasable radiotherapy.