射波刀治疗结直肠癌肝转移临床观察

  目的  研究射波刀(Cyberknife)治疗结直肠癌肝转移癌的临床疗效。  方法  回顾性分析2006年10月至2012年5月收治的22例结直肠癌肝转移患者临床资料。患者病灶数1~4个, 射波刀治疗前一周在CT或B超引导下穿刺植入金标于肿瘤内或距肿瘤2 cm范围内。根据肝转移灶部位不同给予放疗总剂量为(39~50)Gy(/3~6)次。射波刀治疗期间患者均不行同步化疗。  结果  所有患者均顺利完成全程放疗。中位生存期50(15~55)个月, 1、2、3年的生存率分别为100.0%、94.0%和72.5%。全组患者的无进展生存期中位数28(2.3~44)个月。1年及以上的局部控制率86.2%, 放疗前接受全身系统治疗局控相对较好(P=0.07)。常见的副反应为Ⅰ~Ⅱ级恶心、呕吐及乏力, 无Ⅲ级以上急性不良反应。  结论  射波刀治疗结直肠癌肝转移安全有效。 

Clinical outcomes of Cyberknife treatment for liver metastases of colorectal cancer

  Objective  This study aims to evaluate the clinical efficacy of Cyberknife for treating colorectal cancer(CRCa) patients with liver metastases.  Methods  Data of 22 CRCa patients with liver metastases were retrospectively studied.All patients were admitted to Tianjin Cancer Hospital from October 2006 to May 2012.They were implanted with a gold marker in the lesions or around the tumor less than 2 cm under computer tomography or ultrasound.The total radiation dose was(39-50) Gy/(3-6) fractions according to the location of liver metastases.None received concurrent chemotherapy during Cyberknife radiotherapy.  Results  All patients successfully completed the Cyberknife treatment.The median overall survival was 50 months(range, 15 to 55 months).The one-, two-, and three-year survival rates were 100%, 94%, and 72.5%, respectively.The median progression-free survival was 28 months(range, 2.3 to 44 months).The local control for one year or more was 82.6%.The patients that received systemic therapy before Cyberknife showed relatively good local control(P= 0.07).The most common toxicity was grade 1 or 2 nausea, vomiting, and weakness.No grade Ⅲ or worse acute toxicity was found.No late toxicity was also observed.  Conclusion  Cyberknife is a safe and effective treatment for CRCa patients with liver metastases.