射波刀治疗26例肾上腺肿瘤患者的临床分析  

Clinical analysis of cyberknife radiosurgery in the treatment of 26 Patients with adrenal gland neoplasms

作　　者：李静[1,2] 武新虎[2] 刘志冰[1,2] 李兵[2] 王振[2] 朱锡旭[2] 

机构地区：[1]南京大学医学临床学院 [2]南京军区南京总医院放疗科,南京210002

出　　处：《中国肿瘤临床与康复》2013年第7期730-733,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨射波刀(CK)治疗肾上腺肿瘤的疗效和安全性。方法回顾性分析2009年3月至2012年3月期间,应用CK治疗的26例肾上腺肿瘤患者的完整病例资料其中,原发性肾上腺肿瘤6例,转移性肾上腺肿瘤20例。4例患者联合化疗,2例患者联合免疫治疗。平均肿瘤体积72.1cm3,处方剂量30～50Gy,分割次数3～5次,等剂量线58%～80%。CK治疗后1～3个月复查腹部CT,观察近期疗效,每3个月随访一次,随访时间为3～39个月。结果 3例完全缓解,13例部分缓解,5例稳定,5例进展,总有效率为61.5%,疾病控制率为80.8%。所有患者耐受性良好,主要的不良反应为乏力、上腹部不适,无3级或者3级以上不良反应发生;其中1例患者发生放射性肠炎,积极治疗后好转。结论 CK是治疗肾上腺肿瘤的有效治疗手段,安全性好,不良反应轻。远期疗效有待进一步随访研究。Objective The aim of this study is to determine the effectiveness and safety of robotic stereotactic radiotherapy-cyberknife with image guidance and real-time respiratory tracking against adrenal gland neoplasms patients.Methods A review of treatment details and outcomes for 26 patients treated by cyberknife at the cyberknife center of nanjing general hospital of nanjing military command between March 2009 and March 2012 is presented.Of the 26 patients,6 were constitutional cancer and 20 were metastatic cancer.6 patients received other forms of therapy such as chemotherapy and immunotherapy.A total dose of 30-50Gy was prescribed to the 58%-80% isodose line and given in three to five fractions were followed every 3months.Results 3 patents had complete radiographic response,13 patients showed PRs,5 patients showed SDs,5 patients showed PRs（reduction in tumor size）,but developed distant metastases.Response rate was 61.5% and disease control rate was 80.8%.All patients tolerated the radiosurgery well,fatigue being the main side effect.No grade 3 or above toxicity was encountered.Conclusions In this small cohort of patients with adrenal gland neoplasms,Cyberknife seems to be a safe and has good therapeutic effects with slight adverse reaction,but long time follow-up is necessary to evaluate the survival date and late toxicity.

关 键 词：射波刀 立体定向放射治疗 肾上腺肿瘤 

分 类 号：R736.6[医药卫生—肿瘤]