82例巨大原发性肝癌的伽玛刀放射治疗  

Super gamma knife stereotaxis radiation therapy for 82 cases of massive primary liver cancer

作　　者：党亚正[1] 张红宾[1] 陆婉玲[1] 吴发伟[1] 雷续虎[1] 白海珍[1] 

机构地区：[1]解放军第323医院肿瘤放射治疗中心,陕西西安710054

出　　处：《现代肿瘤医学》2011年第2期318-320,共3页Journal of Modern Oncology

摘　　要：目的:巨大肝癌手术难度大,一般多采用非手术疗法,效果较差。本研究旨在评价无法手术切除巨大肝癌伽玛刀放射治疗疗效。方法:2004年10月至2006年10月,对82例无法手术切除的直径≥10cm原发性肝癌进行伽玛刀治疗,按照UICC分期(2002),其中T2期21例,T3期33例,T4期28例,均为N0,合并有门脉癌栓(PVTT)35例,根据Chind-Pugh肝硬化分级,A级60例,B级22例,可见肿瘤体积(GTV)为(710±213)cm3,(510-1532)cm3,每次分割剂量4-8Gy,照射次数为(10±2)次(8-14)次,肿瘤剂量(50.4±5.8),每周2-5次。结果:11例患者伽玛刀治疗后3个月内死亡,未能评价疗效,总有效率51%(36/71),1、2和3年生存率分别为45%、24%和19%。T分期、门脉癌栓、TACE和分割剂量方法对生存率的影响差异无显著性,Chind-Pugh分级是独立的预后因子(P=0.051,相对危险度=2.513)。结论:伽玛刀对于无法手术切除巨大肝癌有一定的疗效,Chind-Pugh分级是独立预后因子。Objective：The majority of massive primary liver cancer （PLC） patients are technically unresectable or medically inoperable,there have not been any really effective treatment modalities and the non - surgical modalities have resulted in very. poor survivals. Our objective was to evaluate the efficacy of unresectable massive PLC patients received super gamma knife stereotaxis radiation therapy. Methods： Total of 82 unrecsectable PLC （tumor size ≥ 10cm） patients were treated with super gamma knife stereotaxis radiation therapy, T2 stage 21 cases, T3 33 cases T4 28 cases, none of the patients had lymph node metastasis. Portal vein tumor thrombosis was presented in 35 patients. Child - pugh Grade A of liver cirrhosis was presented in 60 eases, Child - pugh Grade B 22 eases. The mean value of GTV was （710±213）cm3（510- 1532）cm3. All patients received a total dose of （50.4 ±5.8）Gy, 4 -86Gy perfraction, 2 - 5 times per week. Results： 11 cases died in 3 mouths were not evalutaed. The efficiency rate （ CR ＋ PR） was 51% ,the overall survival rates at 1,2, and 3 year were 45% , 24% , 19% , respectively. T stage, GTV, and fraction size had no significant impact on the overall survival. Child - pugh Grade had significant impact on survival. （P = 0.051, RR = 2.513 ）. Conclusion： Super gamma knife had definitive impact on the overall survival of massive PLC, Child -pugh Grade were independent prognostic factor.

关 键 词：肝肿瘤 放射治疗 伽玛刀 

分 类 号：R735.7[医药卫生—肿瘤]