伽玛刀治疗小肝癌临床研究

目的 探讨体部伽玛刀治疗原发性、转移性小肝癌的方法和疗效．方法 肝癌病人22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，制定治疗计划．伽玛刀治疗方案采用分次立体定向放射治疗，计划靶体积边缘剂量4.0～6．0Gy／次，50％～85％等剂量曲线作为剂量参考，3～5次／周，共治疗6～13次。结果 治疗后3个月影像学复查肿瘤消失6例（27．3％），缩小12例（54、5％），无变化4例（18．2％），有效率81．8％。无放射性肝炎等严重放疗反应发生。结论 伽玛刀治疗小肝癌是一种有效方法，可提高肝脏恶性肿瘤的局部控制率，不良反应轻微。FSRT是较为理想的放疗模式。

Clinical Research of Small Hepatocarcinoma with Stereotactic Radiotherapy

Objective To research therapeutic effectiveness of fractional stereotactic radiotherapy(FSRT) in patients with small hepatocarcinoma.Methods To work out radiotherapeutic plan in 22 patients on the basis of the carcinoma location,clinical target volume(CTV),patient health condition and therapeutic aim with Gamma-knife. The given edge dose to the planning target volume(PTV)was 4.0~6.0Gy for 6~13 times, 50%~85% isodose curve as refference and the tumor absorded dose was 50~55Gy,3~5 times per week.Results 22 patients received CT or MR test.The carcinoma disappeared in 6 patients(27.3%), shrank in 12(54.5%),no varies in 4(18.2%). The complete remission and partial remission for the tumor were 81.8%.There was no evidence to confirm any radiohepatitis and other serious side effect.Conclusion FSRT for small hepatocarcinoma is an effective method and can improve the local control rate.The injury of surrounding normal tissue is mild.