【作者】 龙志雄； 王建国； 李卫东； 杨士勇； 彭云武； 蔡鹏； 刘苇；

【Author】 LONG Zhi-xiong1,WANG Jian-guo1,LI Wei-dong2,YANG Shi-yong1,PENG Yun-wu1,CAI Peng1,LIU Wei1 1.Department of Radiation Therapy,Jingmen Tumor Hospital,Jingmen 448000,China;2.Jingshan County People’s Hospital

【机构】 湖北荆门市肿瘤医院放疗中心； 京山县人民医院外科；

【摘要】 目的观察γ刀治疗原发性小肝癌的远近期疗效和放疗不良反应。方法37例原发性小肝癌患者采用体部γ刀放疗。50%~60%等剂量线包绕PTV,60%~70%等剂量线包绕GTV,GTV生物等效剂量达80Gy以上。27例患者配合TACE1~2次。结果完全消失9例,部分缓解22例,稳定4例,进展2例。肿瘤局控率83.78%(31/37),1~5年生存率分别为78.38%(29/37),62.16%(23/37),43.24%(16/37),32.43%(11/37),33.3%(5/15)。平均生存期为31月。单发病灶4年生存率达55.56%(11/20),疗效与根治手术生存情况相接近,不良反应可以耐受。结论对于拒绝手术或不能手术的原发性小肝癌患者,体部γ刀不失为一种较为有效的根治治疗手段,但合适的总剂量和分次剂量尚需进一步探讨。更多还原

【Abstract】 Objective To investigate the short and longterm therapeutic effectiveness and complication of body-γ-knife in patients with small hepatocellular carcinoma(SHCC).Methods Thirty-seven patients with SHCC were treated by bodyγ-knife therapy.The isodose curve(50%~60%) was covered about planning target volume(PTV),The isodose curve(60%~70%) was covered about gross tumor volumes(GTV).The biological effective dose is 80 Gy at least to the GTV.Twenty-seven patients was treated in combination with TACE 1 or 2 times.Results Tumor disappeared in 9 patients,tumor size decreased in 22 patients,remained unchanged in 4 patients,and enlarged in 2 patients.The local control rates were 83.78%(31/37).The overall survival rate of 1、2、3、4、5-year was 78.38%(29/37),62.16%(23/37),43.24%(16/37),32.43%(11/37),33.3%(5/15).The median follow-up duration was 27 months.The overall survival rate of 4 year with solitary lesion was 55.56%(11/20).The therapeutic effectiveness is comparable to radical operation with acceptable complication.Conclusion Body-γ-knife radiotherapy is a feasible approach of radical cure for patients refuse operation or are not suitable for operation. However,the suitable total dose and fractional dose need further discussion.更多还原