【摘要】 目的　探讨三维立体定向适形放射治疗在肝脏转移性肿瘤中的应用价值。方法　用三维立体定向适形放射技术治疗转移性肝瘤 ,优化指标 :每次剂量 2～ 3Gy时 ,90 %的等剂量面包绕PTV ;每次剂量 8Gy时 ,70 %～ 80 %等剂量面包绕PTV。平均肝脏剂量小于 30Gy。给量 2Gy/次 ,1次 /日 ,5天 /周。照射次数 2 5～ 30次 ,总剂量为 5 0Gy～ 6 0Gy。或者 8Gy/次 ,3次 /周 ,共 3次。结果　在放疗结束后 2个月用腹部CT进行评价 ,有效率 (CR +PR) 5 0 %。 3年局部无进展生存率 75 %。放疗中后无严重并发症发生。结论　三维立体定向适形放射治疗在不增加治疗并发症基础上 ,能明显提高肝转移性癌的局部控制率。我们认为晚期病人出现肝转移时 ,在其它部位病灶尚稳定的情况下可选择三维立体定向适形放射治疗更多还原

【Abstract】 Objective To evaluate the application of three-dimensional conformal radiotherapy on patients with liver metastases cancer.Methods We treated patients with liver metastases cancer by the application of technique of three-dimensional conformal radiotherapy.The optimized index:planning target volume(PTV)received a minimum of 90% of the prescribed dose for 2～3 Gy per fraction,planning target volume(PTV)received a minimum of 70%～80%of the prescribed dose for 8 Gy per fraction.The mean liver dose not reached 30 Gy.Treatment dose:the total irradiation dose is 50～60 Gy in daily fractions of 2 Gy five fractionsl week or 8 Gy per fraction×3 times week.Results Patients would be evaluated by CT in two months after radiotherapy.The effective rate(CR+PR) was 50%. 3-year local recurrence-free survival rate was 75%.There were no serious complication during radiotherapy and follow-up.Conclusion Three-dimensional conformal radiotherapy can improve the local control on the treatment of liver metastases neoplasm and don’t increase the treatment complication.When other site lesion of patients with liver metastases neoplasm is stable,we can use three-dimensional conformal radiotherapy to treat this kind of patient.更多还原