射波刀与大分割三维适形放疗治疗原发性肝癌的疗效比较  

Clinical efficacy of cyberknife versus hypofractionated three dimensional conformal radiotherapy in hepatocellular carcinoma:A comparative study

作　　者：张秋琪 汪延明[2] 

机构地区：[1]锦州医科大学济南军区总医院研究生培养基地,辽宁锦州121001 [2]济南军区总医院放疗科,山东济南250031

出　　处：《解放军医学院学报》2016年第8期819-822,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的比较大分割三维适形放疗（3D conformal radiotherapy,3DCRT）与射波刀（cyberknife,CK）治疗原发性肝癌的临床疗效和不良反应。方法回顾分析济南军区总医院放疗科2013年6月-2015年6月行大分割3DCRT及CK治疗的原发性肝癌患者资料,其中CK治疗组30例,3DCRT组39例,两组患者基线资料具有可比性,CK组36～50 Gy/2～5 f,1次/d,3DCRT组31.5～66 Gy/7～19 f,1次/d或隔日1次。结果随访时间为6～30个月,随访率95.65%。CK组、3DCRT组近期有效率分别为73.33%、64.10%（P=0.606）,1年生存率分别为70.84%、56.67%（P=0.473）,不良反应发生率分别为16.67%、41.03%（P=0.029）,肝功能下降分别为2例、9例,放射性肝炎分别为0例、2例。结论射波刀较大分割三维适形治疗原发性肝癌有一定的局部控制优势及生存优势,但不明显,不良反应相对较小。Objective To observe the efficacy and adverse effects of cyberknife（CK） versus hypofractionated（HF） three-dimensional conformal radiotherapy（3DCRT） for patients with hepatocellular carcinoma（HCC）. Methods In this retrospective study, clinical data about 69 patients（CK group： n=30, 3DCRT group： n=39） with hepatocellular carcinoma who were treated by cyberknife or hypofractionated three-dimensional conformal radiotherapy in department of radiation oncology, Jinan Military General Hospital from June 2013 to June 2015 were analyzed. Baseline data of patients in the two groups were comparable. Patients in CK group received total dose of 36-50 Gy/2-5f, 1 fraction/day, while patients in 3DCRT group at a total dose of 31.5-66 Gy/7-19 f, 1 fraction/day or once every other day. Results The follow-up time was 6 to 30 months with the follow up rate of 95.65%. The short-term objective response rates in CK group and 3DCRT group were 73.33% vs 64.10%（P=0.606）, the 1-year overall survival rates were 70.84% vs 56.67%（P=0.473） and the rate of side effect were 16.67% vs 41.03%（P=0.029）. The number of liver function deterioration cases was 2 vs 9, and the radiationinduced liver disease was 0 vs 2. Conclusion Compared with the treatment of hypofractionated three-dimensional conformal radiotherapy, cyberknife has low side effect rate for patients with hepatocellular carcinoma, while the local control and survival advantage are not obvious.

关 键 词：射波刀 三维适形放射治疗 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤]