体部伽玛刀治疗肝门区肿瘤临床观察  

Clinical effects of body γ-knife in patients with hepatic hilar carcinoma

作　　者：党亚正 陆婉玲 卫伟 雷续虎 李小龙 

机构地区：[1]解放军323医院肿瘤中心,陕西西安710054

出　　处：《现代肿瘤医学》2012年第11期2335-2337,共3页Journal of Modern Oncology

摘　　要：目的:探讨体部立体定向放疗(stereotactic body radiotherapy,SBRT)治疗无法手术的肝门区肿瘤的疗效及毒副作用。方法:2006年10月至2010年6月,对63例肝门区无法手术肿瘤进行SBRT,每次分割剂量(3-6)Gy,照射次数6-15次,肿瘤剂量(39-60)Gy每周2-5次。治疗后1月、3月评价疗效,1年、2年评价患者的生存率。结果:1月CR 15例(23.8%)、PR 34例(54.0%)、SD 11例(17.5%)、PD 3例(4.8%),总有效率78.8%。总胆红素和直接胆红素均较治疗前下降,36例(36/48,75%)患者转为正常,门脉癌栓有效率40.9%。6例患者在治疗3个月内死亡,未能进行以后的疗效评价,3月CR 22例(34.9%)、PR 32例(50.8%)、SD 3例(4.8%),总有效率85.7%(54/63)。总胆红素和直接胆红素全部转为正常为40例(40/48,83.3%),其余5例也接近正常。门脉癌栓有效率63.6%。≤5cm肿瘤CR 72.2%(13/18),CR+PR 94.4%(17/18),>5cm CR 20%(9/45),CR+PR 82.2%(37/45)。患者1年生存率79.4%(50/63)、2年生存率42.9%(27/63)。结论:肝门区肿瘤SBRT是一种安全、有效的治疗方法。Objective：To investigate the effect of stereotactic body radiotherapy（SBRT） in treatment of hepatic hilar tumors.Methods： From October 2006 to June 2010,63 cases of hepatic hilar tumors inoperable tumor were treated by SBRT,dose fractionation 3-6Gy,6-13 times irradiation,total dose（40-60）Gy,（2-5） times/week.After 1,3 month to evaluate therapeutic efficiency and 1 year,2 year survival rate.Results： After 1 month of treatment CR 15（23.8%）,PR 34（54.0%）,SD 11（17.5%）,PD 3（4.8%）,the total efficiency was 78.8%.Total bilirubin and direct bilirubin decreased to normal after treatment in 36（36/48,75%）,efficiency of portal vein tumor thrombus was 40.9%.6 patients died within 3 months,failed to efficacy evaluation.After 1 month of treatment,CR 22（34.9%）,PR 32（50.8%）,SD 3（4.8%）,the total effective rate was 85.7%（54/63）.Total bilirubin and direct bilirubin were converted to normal in 40 cases（83.3%）,five cases were close to normal.The effective rate of portal vein tumor thrombus was 63.6%.The effective rate of tumor diameter ≤5cm was CR 72.2%（13/18）,CR ＋ PR 94.4%（17/18）,tumor diameter 〉5cm CR 20%（9/45）,CR ＋ PR 82.2%（37/45）.1-year survival rate was 79.4%（50/63）,2-year survival rate was 42.9%（27/63）.Conclusion： SBRT is a safe and effective treatment to hepatic hilar tumors.

关 键 词：肝门区肿瘤 立体定向放疗 治疗 

分 类 号：R735.7[医药卫生—肿瘤]