射波刀治疗原发性肝癌的临床研究  

Clinical Study of Cyber Knife Treatment for Patients with Primary Hepatic Carcinoma

作　　者：彭巍[1] 冯国生[1] 梁平[1] 陆合明[1] 卢幻真[1] 

机构地区：[1]广西壮族自治区人民医院临床肿瘤中心,广西南宁530021

出　　处：《中国医药指南》2015年第14期1-3,共3页Guide of China Medicine

摘　　要：目的通过观察射波刀（Cyber Knife）治疗原发性肝癌的临床疗效及不良反应,探讨射波刀在原发性肝癌治疗上的临床应用价值。方法回顾性分析2008年1月至2011年8月收治的78例未经手术、肝移植等治疗的原发性肝癌患者,其中单纯射波刀治疗38例,射波刀联合灌注栓塞化疗（transcatheter arterial chemoembolization,TACE）40例。观察患者治疗后不良反应、疾病控制率（disease control rate,DCR）、无疾病进展时间（progression free survival,PFS）、患者1年和2年的总生存率（Overall survival,OS）。结果接受射波刀治疗的肝癌患者均显示出较好耐受性,不良反应率低,多数为1-2级不良反应。78例患者经治疗后3例CR,18例PR,47例SD,10例PD,DCR为87.2%,中位PFS 11个月。患者1年和2年OS分别是78.2%和66.9%。在亚组分析中,射波刀联合TACE治疗患者中2例CR,10例PR,24例SD,4例PD,DCR为90.0%,中位PFS 15个月,1年和2年OS分别是82.1%和76.2%。单纯射波刀治疗患者中1例CR,8例PR,23例SD,6例PD,疾病控制率DCR为84.2%,中位PFS 7个月,1年和2年OS分别是73.3%和53.3%。两组患者的DCR、中位PFS、1年及2年OS差异无统计学意义（P值分别为0.670、0.105、0.241和0.164）。结论单纯射波刀及射波刀联合TACE治疗原发性肝癌均取得较好的治疗效果,不良反应小,提示射波刀在肝癌治疗上有重要作用。Objective By observing the clinical efficacy and adverse reactions of CyberKnife treatment for patients with inoperable primary hepatic carcinoma（PHC）, this study was to explore the clinical value of CyberKnife for PHC. Methods This retrospective analysis enrolled 78 cases of primary liver cancer patients treated without surgery or liver transplantation from January 2008 to August 2011.38 patients were treated with CyberKnife, 40 patients were treated with CyberKnife combined with TACE. We observed the toxicity, disease control rate （DCR）, progression free survival （PFS）, 1 year and 2 years overall survival （OS） after the treatment of CybeKnife. Results After the treatment of CyberKnife, patients showed well tolerability. Adverse reaction rate was low. Most adverse reactions were I-II degree. All patients： 3 CR,18 PR,47 SD,10 PD,DCR 87.2%, median PFS was 11 months, 1 year and 2 years OS were 78.2% and 66.9%. In the subgroup analysis： The combined therapy： 2 cases CR, 10 cases PR, 24 cases SD, 4 cases PD, DCR 90.0%,median PFS was 15 months, 1 year and 2 years OS were 82.1% and 76.2%. The simple CyberKnife therapy： 1 ease CR, 8 cases PR, 23 cases SD, 6 cases PD, DCR 84.2%, median PFS was 7 months, 1 year and 2 years OS were 73.3% and 53.3%. Between two subgroups, DCR, PFS, 1-year and 2-year OS were no significant difference （P=-0.670,0.105,0.241,0.164）. Conclusion CyberKnife treatment for PHC can achieve good therapeutic effect and low toxicity, showed that CyberKnife played an important role in the treatment of PHC.

关 键 词：射波刀 立体定向放疗 TACE 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]