γ-刀与X-刀治疗中晚期肝癌的疗效  

Evaluation of γ-knife and X-knife for middle stage or advanced hepatic carcinoma.

作　　者：齐宇红[1] 梁军[1] 邵秋菊[1] 梁昉[1] 赵品婷[1] 袁慧琴[1] 高宏[1] 

机构地区：[1]第四军医大学唐都医院放疗科,陕西西安710038

出　　处：《现代肿瘤医学》2006年第1期55-57,共3页Journal of Modern Oncology

摘　　要：目的 探讨γ-射线与X射线立体定向全身治疗系统（简称γ-刀与X-刀）治疗中晚期肝癌的近期疗效。方法 对89例中晚期肝癌患者行立体定向适形放射治疗（SCRT）。分为两组：γ-刀组46例（52个病灶）；X-刀组43例（47个病灶）。均在各自立体定向放疗定位系统下以5mm层厚CT连续扫描靶区，根据三维重建图像资料应用三维治疗计划系统确定治疗方案。^60Coγ射线使50％～70％等剂量曲线包绕肿瘤边缘，6MV—X射线使80％～90％等剂量曲线包绕肿瘤边缘，照射剂量均为30—45Gy／6—10Fractiort／10—20d。对比分析γ-刀组与X-刀组治疗前后的症状、影像学改变、血清甲胎蛋白（AFP）、血白细胞及肝功能指数，根据WHO标准，按治疗后1～3个月时的CT或MRI评价各自近期疗效。结果 γ-刀组：12个为CR（23．1％），26个为PR（50．0％），10个为NC（19．2％），4个为PD（7．7％）；X-刀组：11个为CR（23．4％），23个为PR（48．9％），8个为NC（17．0％），5个为PD（10．6％）。并对两组治疗后血AFP降低率、血白细胞减少发生率及肝功能指数进行对比：γ-刀组分别为83．8％、19．6％和6．5％；X-刀组分别为85、7％、16．3％和7、0％。γ-刀组与X-刀组统计学差异均无显著性意义（P〉0．05）。结论 立体定向适形放疗是治疗中晚期不能手术肝癌有效的无创治疗手段。γ-刀与X-刀治疗的疗效相当，均是控制局部病灶、提高患者生存质量、具有较好近期疗效的治疗办法。Objective To evaluate the therapeutic effect of γ- ray and X - ray stereotactic conform radiotherapy （γ -knife and X -knife） on middle stage or advanced hepatic carcinoma. Methods Between Jan 2001 and Dec 2003, 89 patients with middle stage or advanced hepatic carcinoma Underwent stereotactic conform radiotherapy （SCRT） . All patientswere were divided into γ - knife group and X - knife group . 46 patients inγ - knife group received γ- ray SCRT, 43 patients in X -knife group received X -ray SCRT. 100% clinic tumor volume（CTV） received 50% -70% prescribed irradiation dose in γ- knife group and 100% clinic tumor volume（CTV） received 80% -90% prescribed irradiation dose in X - knife group. Irradiation dose was 30 - 45Gy/6 - 10fractiort/ 10 - 20day in each group. 6MV - X ray was used in X - knife group. CT image studies were conducted to evaluate the therapeutic effects before and in the follow - up period of 1 - 3 month after SCRT, with alpha - feto - protein （AFP） levels also tested. Results CR was of γ - knife group and X - knife group 23.1% and 23.4% respectively and PR was 50.0% and 48.9% respectively. AFP levels of these patients with hepatic carcinoma were mostly significantly decreased. Conclusion SCRT is an effective method for middle stage and advanced hepatic carcinoma, Both γ - knife and X -knife appear to be less - invasive, safe and effective treatment for middle stage and advanced hepatic carcinoma.

关 键 词：肝癌 放射治疗 立体定向 疗效 

分 类 号：R735.7[医药卫生—肿瘤]