半肝交替三维立体定向适形放射治疗原发性弥漫性肝癌的近期疗效

目的探讨半肝交替三维立体定向适形放射(X刀)治疗在肝脏原发性弥漫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原发性弥漫性肝癌,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。每半肝照射8~12次,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)68.8%。1年局部无进展生存率75%。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,能明显提高原发性弥漫性肝癌的局部控制率,原发性弥漫性肝癌病人可选择半肝交替三维立体定向适形放射技术作为姑息治疗的有效选择之一。

The recent effect of semi-liver alternate and three - dimensional conformal radiotherapy for patient with liver primary pervasive cancer

Objective To evaluate the application of three-dimensional conformal radiotherapy on patients with liver primary pervasive cancer.Methods We treated patients with liver primary pervasive cancer by the application of technique of semi-liver and three-dimensional conformal radiotherapy.The optimized index:planning target volume(ptv)received a minimun of 90% of the prescribed dose for 2~3Gy per fraction,The mean liver dose not reached 30 gy.8~12 fractions of semi-liver,3 times once week.Results Patients would be evaluated by CT in two months after radiotherapy.The effective rate(CR PR) was 56.3%.1-year local recurrence-free survival rate was 60.0%.There were no serious complications during and after radiotherapy.Conclusion Three-dimensional conformal radiotherapy can improve the local control on the treatment of liver primary pervasive cancer and don't increase the treatment complication.When other site lesion of patients with liver primary pervasive 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.