42例肾上腺转移癌射波刀治疗的临床观察  

Clinical efficacy of CyberKnife radiosurgery in treatment of adrenal metastases： a study of 42 patients

作　　者：赵宪芝 庄洪卿[1] 袁智勇[1] 王境生[1] 董洋[1] 陈华明[1] 李丰彤[1] 宋勇春[1] 王平[1] 

机构地区：[1]国家癌症临床研究中心、天津市肿瘤防治重点实验室、天津医科大学肿瘤医院放疗科射波刀中心,天津300060

出　　处：《中华放射肿瘤学杂志》2015年第3期271-274,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 探讨SBRT技术治疗肾上腺转移癌的安全性和有效性.方法 回顾分析2006-2013年间应用射波刀治疗42例肾上腺转移癌患者的资料,以疗后1个月复查观察近期疗效.采用WHO的RECIST1.1标准进行评价,采用RTOG或EORTC放射损伤分级标准评价不良反应,采用Kaplan-Meier法计算生存率和LC率.结果 42例47个靶点纳入研究,其中14个病灶达CR,13个病灶达PR,总有效率为57％.1、2年样本数分别为25、19个靶点,1、2年LC,OS,PFS率分别为87％、60％,53％、41％,17％、8％.GTV＜2.5 cm^3、BED＞ 80 Gy、年龄＞60岁均有助于提高局部PFS期.治疗后乏力、纳差、恶心、呕吐等胃肠道反应和骨髓抑制主要为1、2级反应,只有1例出现3级胃肠道反应.结论 SBRT技术治疗肾上腺转移癌不良反应轻且LC效果好.Objective To investigate the safety and efficacy of stereotactic body radiotherapy （SBRT） in the treatment of patients with adrenal metastases.Methods The clinical data of 42 patients with adrenal metastases who were treated with CyberKnife radiosurgery from 2006 to 2013 were retrospectively analyzed.Short-term outcomes at 1 month after treatment were evaluated.The evaluation was performed using RECIST 1.1 criteria by the World Health Organization.The adverse reactions were assessed using RTOG/EORTC radiation injury grading criteria,and the overall survival （OS） and local control （LC） rates were calculated using the Kaplan-Meier method.Results Among 47 targets in 42 patients,14 lesions showed a complete response,and 13 lesions showed a partial response,with an overall response rate of 57%.The sample sizes at 1 year and 2 years were 25 and 19,respectively.The 1-and 2-year LC rates were 87% and 60%,respectively.The 1-and 2-year OS rates were 53% and 41%,respectively,and the 1-and 2-year progression-free survival （PFS） rates were 17% and 8%,respectively.The PFS was substantially improved in patients with a gross target volume less than 2.5 cm^3,a biologically equivalent dose higher than 80 Gy,and older than 60 years of age.The adverse reactions after treatment were mainly grade 1 or 2 gastrointestinal reactions including fatigue,anorexia,nausea,and vomit,and grade 1 or 2 bone marrow suppression.Only one patient showed grade 3 gastrointestinal reactions.Conclusion SBRT is a safe and effective method in the treatment of adrenal metastases with mild adverse reactions and good LC rates.

关 键 词：肾上腺 肿瘤转移/放射疗法 放射疗法 射波刀 治疗结果 

分 类 号：R736.6[医药卫生—肿瘤]