伽玛刀治疗原发性肝癌296例的临床研究  

Clinical research on treatment of PHC by gamma knife( a report of 296 cases)

作　　者：吴盛荣[1] 毛树权[1] 黄凤鸣[1] 肖茜[1] 

机构地区：[1]解放军324医院肿瘤科,重庆400020

出　　处：《西南国防医药》2015年第1期48-51,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨伽玛刀治疗原发性肝癌（PHC）的近期疗效及1、2、3年的累积生存率。方法 296例经临床确诊的PHC患者应用OPEN式KLF-A型体部伽玛刀进行治疗,平均PTV边缘剂量为3.5-5.0 Gy,GTV边缘剂量为5.5-7.0 Gy/d,瘤体中心剂量为8.0-10 Gy/d,根据肝功能状况连续治疗6-10 d,以后连续随访3年。按Kaplan-Meier计算生存率。结果296例近期疗效总有效率为82.8%（245/296）;小肝癌（直径≤5 cm）1、2、3年累计生存率为81.2%、70.1%、43.3%,大肝癌（直径为5-20 cm）为84.3%、40.5%、28.1%;3年生存率为51.5%;放射性肝损伤发生率为7.1%,无放射性相关死亡病例。肝功能状况是决定生存期的重要因素,Child-Pugh A级的生存期明显高于B级（P〈0.05）。结论 OPEN式KLF-A型体部伽玛刀对PHC有良好的治疗效果,有必要进一步开展多中心、大样本研究。Objective To observe the short-term curative effects of gamma knife on treatment of primary hepatocellular carcinoma（ PHC） and the cumulative survival rate in the first,second and third year. Methods Total 296 PHC patients having been identified clinically were sampled for the analysis and they were treated with OPEN KLF-A body gamma knife with an average PTV margin dose of 3. 5-5. 0 Gy,GTV margin dose of 5. 5-7. 0 Gy and tumor central dose of 8. 0-10 Gy. They were continuously treated for 6-10 days according to their liver function conditions and then were followed up for continuous three years. The survival rate was determined by Kaplan-Meier method. Results The total effective rate of short-term curative effect of 296 patients was 82. 8%（ 245 /296）; the cumulative survival rate of the patients with small hepatocellular carcinoma（ diameter ≤5 cm） in the first,second and third year was 81. 2%,70. 1% and 43. 3%,respectively; while large hepatocellular carcinoma was 84. 3%,40. 5% and 28. 1%,respectively; the overall survival in 3 years was 51. 5%; incidence rate of radioactive liver injury was 7. 1% and the radioactive death case was zero. The liver function condition was an important factor of survival; the survival time of Child-Pugh A was significantly higher than that of B（ P〈 0. 05）. Conclusion OPEN KLF-A body gamma knife has favorable curative effect on PHC and it is necessary to further carry out multi-center and large sample studies.

关 键 词：肝癌 伽玛刀 立体定向放射治疗 

分 类 号：R735.7[医药卫生—肿瘤]