射波手术平台治疗中晚期肝癌患者的疗效观察  

The analysis of CyberKnife therapy for middle-late stage hepatoma

作　　者：王义善[1] 贾喜风[1] 王园园[1] 杨柯[1] 杨桂青[1] 王东[1] 王珊珊[1] 

机构地区：[1]滨州医学院附属解放军第107医院国家中西医结合肿瘤治疗重点专科全军肿瘤无创诊疗中心,山东烟台264002

出　　处：《中华临床医师杂志（电子版）》2011年第22期6576-6579,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：全军科技攻关基金(06G034)

摘　　要：目的观察射波刀CyberKnife在中晚期肝癌或肝转移癌患者治疗中的疗效,分析大剂量、短疗程精确放疗在肝癌治疗中的量效关系。方法对40例中晚期肝癌或肝转移癌患者、126个肿瘤病灶予以CyberKnife治疗,每个治疗计划最多包含6个靶区病灶,DT:30～40Gy、分3～5次1周内完成治疗。与曾在我院进行适形放射治疗的40例中晚期肝癌或肝转移癌患者治疗后的近期疗效进行比较。按照世界卫生组织客观疗效评价标准评定近期疗效,并对肿瘤标记物AFP及Zubrod-ECOG-WHO(ZPS)评分。结果影像学1～3个月瘤体内不同程度坏死、部分周边水肿,PET/CT显示摄取18F-FDG明显降低,是一个低代谢病灶,<5cm瘤体显示已无活性病变。放射免疫检测指标部分降低或趋向正常,肝区疼痛改善或消失。结论 CyberKnife由于其适时影像追踪、高度精确、快速短程等优点使中晚期肝癌患者正常组织损伤小、见效快,变不治为可治,值得临床推广应用。Objective To evaluate the application value of CyberKnife for middle-late stage hepatoma,and to analyze the dose-response relationship of the high-dose short-course precise radiotherapy.MethodsA total of 40 patients with 126 tumor lesions and most 6 target areas in one plan were delivered in 3 to 5 fractions to complete the whole treatment in 1 week.ResultsRadiographic study showed tumor shrinkage in different degrees and part peripheral hydrops in 1-3 months.PET/CT indicated that intake of 18F-FDG decreased and it was a hypometabolic tumor lesion.Radiation immunoassays(RIA)revealed partial reduction or tendency to be normal.The recent improvement of the quality of life was significant.ConclusionsWith the advantages of real-time image tracking,highly precise and rapid short-course,CyberKnife make incurable middle-late stage high-difficulty tumors to be cured with minimum injury and prompt effectiveness,and thus,it deserves popularized clinical application.

关 键 词：肝肿瘤 放射外科手术 放射疗法 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]