采用体部伽马刀治疗肺转移瘤的安全性研究  

Evaluation on clinical safety of metastatic tumor of lung treated by Body Gamma Knife

作　　者：李宏奇[1] 吴伟章[1] 王颖杰[1] 李晶[1] 王轩[1] 庞海峰[1] 夏廷毅[1,2] 

机构地区：[1]空军总医院肿瘤放疗科,北京100142 [2]解放军总医院肿瘤放疗科,北京100853

出　　处：《中国医学装备》2013年第7期80-83,共4页China Medical Equipment

基　　金：空军总医院科研基金支持(KZ2009023)"采用现代放疗技术治疗肺转移瘤的临床效果评价研究"

摘　　要：目的:探讨体部伽马刀治疗肺转移瘤的安全性。方法:对52例肺转移瘤患者共计217个病灶进行体部伽马刀治疗,其1个疗程为1～6次,单次治疗病灶最少1个,最多12个,中位数4个;病灶体积为0.13～65.12cm3。辐射源为γ射线。单次照射剂量为3～5Gy,中位数为5Gy,总剂量为30～51Gy,中位数为40Gy,等效生物剂量为39～86.4Gy。结果:全组死亡24例,其中9例死于呼吸衰竭,5例死于多器官功能衰竭,死于肾衰、心衰、肺内病灶复发和脑转移各2例,2例死于大出血。急性辐射损伤主要表现在上消化道、肺和血液学毒性。晚期辐射损伤集中体现在肺组织损伤。不良反应均在RTOGⅡ级以下,急性辐射损伤和晚期辐射损伤III级各2例(占3.8%)。结论:本研究结果表明,体部γ-刀治疗多发性肺转移瘤安全,同时为临床在安全范围内进一步提升照射剂量创造了条件。Objective：To explore clinical safety of body γ-knife in the treatment of metastatic tumor of lung.Methods：We treated fifty-two patients with 217 metastatic tumors of lung who treated by Body Gamma Knife.The frequency is 1～6 times in one course of treatment,1 tumor at least was targeted in single treatment and 12 at most and the mean is 4 tumors.The volume of focuses is 0.13～65.12cm 3.The radiation source is γ-ray,the single dose is 3～5Gy and the mean of it is 5Gy.The total dose is 30～51Gy and the mean of it is 40Gy.The bioequivalent dose is 39～86.4 Gy.Results：The total number of dead cases is 24.Nine of them died in respiratory failure,5cases in multiple organ failure and 2 cases in renal failure,congestive heart failure,local recurrence and brain metastases.Two cases died in hemorrhoea.There was acute radiation injury in upper digestive tract,lung and hematological system.The injury of lung was the main symptom of 6-month radiation therapy.Side-effect is almost less than II degree.There are two cases with acute radiation injury and III degree of late radiation injury （3.8%）.Conclusion：Body γ-knife is a safe method of treating pulmonary metastasis.It may create the chance of dose elevation for radiation.

关 键 词：安全性 肿瘤转移 肺 体部伽马刀 

分 类 号：R734.2[医药卫生—肿瘤]