肝癌三维适形放射治疗临床疗效评价  

Evaluation of the Efficacy of Three Dimensional Conformal Radiation Therapy on Primary Liver Cancer

作　　者：牛道立[1] 胡慧玲[2] 盛蓁[2] 任春丽[2] 曲志锋[2] 王培[2] 

机构地区：[1]广州医学院第一附属医院放疗科,广州市510120 [2]河南科技大学第一附属医院χ刀中心

出　　处：《中国肿瘤临床》2005年第24期1410-1412,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨三维适形放射治疗原发性肝癌的疗效及放疗反应。方法:从1997年3月到2000年10月,用三维适形放射治疗的方法治疗原发性肝癌患者89例,肿瘤体积36～492cm3,用Elekta公司的TPS设计治疗计划,并根据DVH图进行计划优化。治疗采用6MV-X线,处方剂量4～5Gy/次,隔日照射一次,5～6个共面或非共面野进行适形照射,共治疗8～10次,总剂量40Gy,整个疗程16～20天。近期疗效按WHO实体肿瘤疗效标准评价,正常组织的放射反应按RTOG标准评价。结果:近期疗效:放疗结束后三个月,完全缓解率(CR)为29.2%(26/89),部分缓解率(PR)为49.4%(44/89),总有效率(PR+CR)为78.7%。1、2、3年生存率分别为64.0%(57/89)、41.6%(37/89)和28.1%(25/89)。肿瘤体积越小,疗效越好(P=0.005)。放疗反应主要为消化道反应和肝脏放射性损伤,肝脏的放射性损伤和受照射体积有关。结论:三维适形放射治疗原发性肝癌有较好的疗效,放射反应可以耐受。Objective： To explore the result and side effect of the 3 dimensional conformal radiation therapy （3DCRT） for primary liver cancer. Methods： From Mar. 1997 to Oct. 2000, 89 patients with primary liver cancer were treated with 3DCRT. Radiotherapy was designed by 3-D treatment plan system of the Elekta company. Dose volume histography （DVH） was used to verify and optimize the radio-therapeutic regimen. The total dose was 40 Gy and it was delivered 4-5Gy per fraction, once every other day, with total 8-10 fractions during 16-20 days, using 5-6 coplane or non-coplane for conformal irradiation. The immediate response and side effect were evaluated based on the WHO and RTOG criterion system. Results： Three months after irradiation, the overall immediate response rate （CR＋PR） was 78.7%. The 1-, 2- and 3-year survival rate were 64.0%（57/89）, 41.6%（37/89） and 28.1%（25/89）, respectively. The immediate response was related to the target volume. The smaller the targeted volume, the better the response （X2=18.428, P=0.005）. The side effect of acute irradiation was mainly digestive tract effect and radiation-induced liver injury. The radiation-induced liver injury was also related to the radiated volume of the liver. Conclusions： Three dimensional conformal radiotherapy can be considered as an effective and feasible approach for primary liver cancer, with no any serious complications.

关 键 词：肝肿瘤 放射治疗 适形 预后 

分 类 号：R735.7[医药卫生—肿瘤]