体部立体定向放疗治疗腹膜后转移瘤临床疗效观察

目的:观察全身γ刀立体定向放射治疗(SBRT)腹膜后转移瘤的近期疗效及不良反应.方法:采用超级γ刀（SGS-I型）立体定向放射治疗腹膜后转移癌65例,根据肿瘤的位置、临床靶体积、病人的身体状况与治疗目的,制定放射治疗计划及调整剂量分布.肿瘤体积8.7～1 352.3cm3,等剂量参考曲线50%～60%,周边照射总剂量40～48Gy,分割处方剂量4.0～6.0cGy,重复治疗8～10次,5次/周.结果:治疗前腰背部疼痛不适等40例,治疗结束后1至3个月,症状完全消失32例(80.0%),轻度缓解7例（17.5%）,部分缓解1例(2.5%),症状改善有效率为97.5%.65例病人治疗后2～3个月复查CT或MR,肿瘤消失36例(55.38%),缩小27例(41.54%),无变化2例(3.08%),总有效率96.92%.2级放射性消化系统反应为16.18%,无>2级放射性消化系统反应的发生.结论:全身γ刀治疗腹膜后转移癌临床效果确切,毒副反应较轻.

Clinical analysis of stereotactic body radiotherapy for retroperitoneal metastatic tumor

Objective:To investigate the clinical application and the short-term effect of stereotactic radiotherapy with whole body γ-knife in the patients with retroperitoneal metastatic tumor.Methods:From January 2013 to December 2015,the data of 65 patients with retroperitoneal metastatic tumor were treated by stereotactic radiotherapy with super-gamma-knife,The total radiation dose was 40~48Gy,4.0~6.0Gy/f (50%~60% isodose line),one fraction/d,five days/w.The effect and side effect of stereotactic radiotherapy were analyzed.Results:In 65 patients,the tumor disappeared in 36 cases (55.38%),reduced in 27 cases (41.54%),and unchanged in 2 cases (3.08%)with a response rate of 96.92% 2~3 months after treatment.Among 40 patients,pain in 32 cases of them was greatly alleviated,and pain was partially relieved in 7 patients with a response rate of 97.5% after treatment 1~3 months.Serious complications of radiotherapy were not seen.Conclusion:The clinical results of stereotactic radiotherapy with super-gamma-knife for retroperitoneal metastatic tumor are definitive and safe with mild side effect.