立体定向适形放疗治疗原发性肝癌的近期疗效分析

目的 观察立体定向适形放疗治疗原发性肝癌的近期疗效.方法 28例原发性肝癌患者经Elscint twin flash 螺旋CT机定位后,用Leibinger三维放疗计划系统拟制放疗计划,在Varian直线加速器上实施治疗.平均随访时间为12个月.分析肿瘤反应率、放疗后无肝内肿瘤进展率及放疗后12个月生存率,观察治疗毒副作用.结果 放疗后肿瘤体积反应率为85.7%,放疗后12个月无肝内肿瘤进展率为38.4%,放疗后12个月生存率为70.5%.存活患者无晚期肝损伤.结论 立体定向适形放疗治疗肝癌的毒性较小,对提高肝内肿瘤的局部控制率有一定意义.

Analysis of short-term therapeutic effects for patients with primary liver cancer treated with three-dimensional stereotactic conformal radiotherapy

Objective To evaluate the short-term therapeutic effects for patients with primary liver cancer using three-dimensional stereotactic conformal radiotherapy(3D-CRT).Methods Twenty-eight patients with primary hepatic cancer were treated with 3D-CRT(the average overall dose was 38Gy,localized by Elscint twin flash slice CT,radiotherapy plan was designed by Leibinger three-dimensional radiotherapy planning system and operated on Varian 600C/D liner accelerator).The average follow-up time was 12 months(5-17mon.).Tumor volume response rate,rate of free from tumor progression and survival rate were analyzed.The adverse effects were studied simultaneously.Results According to follow-up CT results 3 months after radiotherapy,2 cases had full responses with disappearance of the tumors,while partial responses with decreased tumors mass were seen in 22 cases,and no response in 4 cases.Tumor volume response rate was 85.7%.The last follow-up CT results showed that in 5 patients there was tumor progression in planning target volume(PTV),in 10 cases there was intrahepatic progression but not in PTV,and in 4 cases extrahepatic tumor growth.Intrahepatic tumor free rates 6 months and 12 months after radiotherapy were 66.5% and 38.4%,respectively.6-month survival rate after radiotherapy was 88.6%,12-month survival rate was 70.5% after radiotherapy.During 3 months of radiotherapy,manifestations of subacute radiation injuries occurred in six patients:gastrointestinal hemorrhage in 2 cases,jaundice in 3 cases and subacute radiation hepatitis in 1 patient.No survivors suffered from long-term liver injury.Conclusions With little adverse effect,3D-CRT could raise the control rate of the hepatic tumor,and also short-term survival rate.There fore,3D-CRT is a valuable treatment for patients with primary liver cancer.