肝转移瘤立体定向适形放疗临床分析  

Clinical analysis of stereotactic conformanl radiotherapy for metastases liver carcinoma

作　　者：郑瑞锋[1] 苏欣[1] 闫敏[1] 百宏灿[1] 聂晓光[1] 于丹丹[1] 黄凯[1] 

机构地区：[1]武警河南总队医院肿瘤科,河南郑州450052

出　　处：《中国现代医学杂志》2005年第21期3330-3332,共3页China Journal of Modern Medicine

摘　　要：目的探讨立体定向适形放疗对肝转移瘤的疗效。方法对63例共121个转移病灶实施立体定向适形放疗,肿瘤中心剂量30～68GY,每次5～8GY,分6～8次,每周2、3次,疗程2～4周,计划靶区体积1.8～130.0cm3,设6￣8个非共面照射野,利用同步铅挡块,80%等剂量线包括靶区边界。结果肿瘤消退有效率(CR+PR)86.8%(105/121),其中CR33.1%(40/121),PR53.7%(65/121),NC10.7%(13/121),PD2.5%(3/121)。肿瘤剂量30￣45GY组:CR14.3%(3/21),50￣58GY组:CR29.4%(20/68)(P<0.05);60￣68GY组,CR53.2%(17/32)(P<0.05)。原发灶病理学类型为鳞癌CR73.3%(11/15);病理学类型为软组织来源CR12.5%(1/8)(P<0.05)。低分化组CR47.2%(17/36)、中高分化组CR27.1%(23/85)(P<0.05)。肿瘤直径<2.0cm组CR75.9%(22/29);肿瘤直径2.0￣5.0cm组CR24.2%(15/62)(P<0.05);肿瘤直径>5.0cmCR10.0%(3/30)(P<0.05)。结论立体定向适行放疗为肝转移瘤治疗的有效手段,疗效与肿瘤剂量、原发灶病理学类型及肿瘤体积大小关系密切。[Objective] To detect the treatment effect of stereotactic conformal radiotherapy for metastases liver carcinoma. [Methods] 63 patients with 121 metastases 30-68 GY, 5-8 GY per times, 6~8 times per course, 2-3 times per week, 2-4week per course, planning target volume（PTV）1.8-130.0 cm3. Among 6-8 irradiation static confrmai fields are delivered. The clinical tumor volume was totally encompassed within the exposure by 80% of the prescribed epual does. [Result] The total effective rate of the treatment, was 86.8%（105/121）, CR 33.1%, PR 53.7% （65/121）, NC 10.7%（13/121）, PD 2.5%（3/121）. The group that tumor center does was 30-45 GY： CP 14.3%（3/12）, The group that tumor center does was 50-58 GY： CR 29.4%（20/68）（P 〈0.05）. The group that tumor center does is 60-68GY： CR 53.2% （17/32）（P 〈0.05）. The group that primary tumor pathological types was squamous cell carcinoma： CR 73.3%（11/15）, The group that primary tumor pathological types soft-tissue cell carcinoma： CR 12.5%（1/8） （P 〈0.05）. The group that low-differentianed cell： CR 47.2%（17/36）, The group that middle or hight-differentiated cell： CR 27.1%（23/85） （P 〈0.05）. The group that tumor less than 2.0 cm in diameter：. CR 75.9%（22/29）, the group that tumor from 2.0 to 5.0 cm in diameter＇. CR 24.2% （15/62） （P 〈0.05）. The group that rumor more than 5.0 cm in diameter： CR 10.0%（3/30） （P 〈0.05）. [Conclusions] The stereotactic conformal radiotherapy is a effective methods for metastases liver carcinoma. The effect is relate to the tumor center does the primary pathological types and the tumor volume.

关 键 词：肝转移瘤 立体定向 适形放疗 

分 类 号：R735.7[医药卫生—肿瘤]