基于主动呼吸门控及容积调强技术的大分割放疗模式治疗肝转移癌的疗效评估  

Efficacy and Safety of Hypofractionated Radiotherapy Associatedwith Active Breathing Control and Volumetric ModulatedArc Therapy for Hepatic Metastasis

作　　者：赵丽君[1] 尹丽[1] 张丝雨 许俊 陈诚[1] 江宁 宋雪[1] 王丽君[1] 张倩[1] 黄蕾[1] 孙丽[1] 何侠[1] ZHAO Li-jun;YIN Li;ZHANG Si-yu;XU Jun;CHEN Cheng;JIANG Ning;SONG Xue;WANG Li-jun;ZHANG Qian;HUANG Lei;SUN Li;HE Xia(The Affiliated Cancer Hospital of Nanjing Medical University&Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research,Nanjing 210009,China)

机构地区：[1]南京医科大学附属肿瘤医院&江苏省肿瘤医院&江苏省肿瘤防治研究所,江苏南京210009

出　　处：《肿瘤学杂志》2023年第2期134-139,共6页Journal of Chinese Oncology

基　　金：中华国际医学交流基金会肿瘤精准放疗星火计划支持(2019-N-11-03)。

摘　　要：[目的]分析主动呼吸门控(active breathing control,ABC)及容积调强技术(volumetric modulated arc therapy,VMAT)进行肝转移癌大分割放疗的疗效及安全性。[方法]分析2018—2021年江苏省肿瘤医院收治的31例肝转移癌患者的临床资料。予ABC及VMAT技术设计50 Gy/10 F或56 Gy/7 F两种大分割放疗计划。治疗前使用三维影像引导及锥形束CT进行在线位置验证。[结果] 31例患者共治疗45个肝转移病灶,均顺利完成放疗。中位随访时间28个月,中位总生存时间27个月。所有患者放疗后1年局部控制率、无进展生存率和总生存率分别为80.6%、41.9%和90.3%。非结直肠癌、结直肠癌患者的1年总生存率分别为82.5%、100%,两组之间有显著性差异(P=0.007)。不同放疗模式之间在局部控制率及总生存率方面无显著性差异(P>0.05)。[结论]基于ABC及VMAT技术的大分割放疗模式治疗肝转移癌安全有效。[Objective]To investigate the efficacy and safety of hypofractionated radiotherapy associated with active breathing control(ABC)and volumetric modulated arc therapy(VMAT)for the treatment of hepatic metastases.[Methods]The clinical data of 31 patients with liver metastases treated in Jiangsu Cancer Hospital from 2018 to 2021 were analyzed.Patients were simulated using ABC and VMAT technique.The prescribed dose was 50 Gy in 10 fractions or 56 Gy in 7 fractions.Three-dimensional image guided radiotherapy and cone beam CT were used before each fraction with online correction.[Results]The median follow-up time was 28 months and the median overall survival time was 27 months.The 1-year local control(LC),disease-free survival and overall survival(OS)were 80.6%,41.9%and 90.3%,respectively.The 1-year OS of patients with primary colorectal cancer was significantly higher than that with primary non-colorectal cancer(100%vs 82.5%,P=0.007).There was no significant difference in the LC and OS for two different hypofractionated radiotherapy modalities(P>0.05).[Conclusion]Hypofractionated radiotherapy associated with ABC and VMAT is an effective alternative local therapy for hepatic metastasis.

关 键 词：肝转移 大分割放疗 主动呼吸门控 结直肠癌 

分 类 号：R735.7[医药卫生—肿瘤]