体部伽玛刀治疗202例肺癌临床疗效观察  

Clinical observation of therapeutic effectiveness of body gamma knife in 202 patients with lung cancer

作　　者：李宏斌[1] 彭海波[1] 戴德银[1] 陈利君[1] 

机构地区：[1]解放军第452医院伽玛刀治疗中心,四川成都610021

出　　处：《现代肿瘤医学》2008年第3期372-374,共3页Journal of Modern Oncology

摘　　要：目的:探讨体部伽玛刀治疗肺癌的近期疗效。方法:采用OUR-QGD型体部伽玛刀治疗肺部肿瘤202例,根据病灶的三维形状及病人的身体状况确定靶点数目、治疗次数及分次剂量。PTV覆盖95%以上CTV,等剂量曲线50%-85%,中位值61.81%,PTV周边照射总剂量2800cGy-5500cGy,分割处方剂量350cGy-800cGy,重复治疗4-12次。结果:治疗后随诊3至15个月,胸痛症状止痛有效率为94.93%。189例病人进行疗效评价,CR29例(15.34%),PR113例(59.79%),NC36例(19.05%),PD11例(5.82%),稳定率为94.18%。病理类型以小细胞未分化癌疗效最佳。肿瘤体积≤30cm3者较肿瘤体积>30cm3者治疗效果明显为好。肿瘤分期早期病人治疗效果较好,中晚期病人经过放射治疗可以减轻临床症状。治疗中与治疗后发生的副反应及放射性损伤均较小。结论:体部伽玛刀治疗肺癌可以使肿瘤局部得到准确的高剂量照射,近期疗效显著,安全可行。Objective：To investigate the short -term therapeutic effectiveness of Body Gamma Knife in patients with lung cancer. Methods： Total of 202 patients with lung cancer were treated by OUR - QGD Body Gamma Knife. The dosage distribution and other radiotherapeutic plans were ＇established on the basis of the carcinoma position and patient health condition. The isodose curve was 50% - 85% and covered about 95% of the target volume. The mean value was 61.81%. The fractional dose was 350cGy -800cGy. and the total dose was 2800cGy -5500cGy. The radiation was performed 4 - 12 times for one patient. Results： 3 - 15 months after treatment,in the 189 cases of followed up,CR 15.34% ,PR59.79% ,NC 19.05% ,PD 5.82%. The regional stability rate（ CR ＋ PR ＋ NC）94. 18%. And 94.93% patientspain was completely controlled. The therapeutic effectiveness of small cell carcinoma was the best. The effectiveness was better in the tumor volume ~〈 30cm^3 than 〉 30cm^3 and in early stage than middle - late stage. The clinical symptom could be abatememt in the patient of middle - late stage. The side effect and irradiation injury were found during and after therapy, but could continue having therapy and recover. Conclusion： Body Gamma Knife can achieve a high local control. It is a safe and reliable treatment option for patients with lung cancer.

关 键 词：立体定向放射治疗 肺癌 近期疗效 伽玛刀 

分 类 号：R734.2[医药卫生—肿瘤]