射波刀立体定向放射治疗小肝癌的临床效果

张弢; 孙静; 何卫平; 李欢; 王卉; 孙颖哲; 朴俊杰; 张军华; 徐慧军; 段学章

doi:10.3969/j.issn.1001-5256.2017.04.019

射波刀立体定向放射治疗小肝癌的临床效果

DOI: 10.3969/j.issn.1001-5256.2017.04.019

解放军第三〇二医院肿瘤放射治疗中心

基金项目:

首都特色基金(Z151100004015002)；解放军三〇二医院院长创新基金(YNKT2014011)；

详细信息

中图分类号: R735.7;R730.55
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出版历程
- 收稿日期: 2016-10-12
- 出版日期: 2017-04-20

Clinical effect of Cyber Knife stereotactic radiosurgery in treatment of patients with small hepatocellular carcinoma

Radiotherapy Center of Oncology, 302 Hospital of PLA

Research funding:

摘要

摘要: 目的评价小肝癌（s HCC）患者接受射波刀立体定向放射外科治疗的疗效和安全性。方法收集2011年3月-2012年12月解放军第三○二医院行射波刀治疗的28例s HCC患者。射波刀治疗总剂量3560 Gy/35次,连续治疗36 d。中位随访时间36个月。依据改良版实体瘤疗效评价标准（mRECIST）进行近期疗效评价,以1、2、3年总生存率和局部控制率作为远期疗效评价指标。采用Kaplan-Meier法分析计算累积生存率和局部控制率。结果 28例患者中,完全缓解17例,部分缓解8例,稳定2例,疾病进展1例,近期有效率89.28%。1、2、3年生存率分别为92.86%、85.71%和78.57%;1、2、3年局部控制率分别为96.43%、92.86%和89.28%。毒性反应主要表现为ⅠⅡ级事件。结论射波刀治疗s HCC是安全、有效的,具有较高的局部控制率、生存率和低毒性反应,可以作为不适合手术治疗的s HCC的替代治疗。
- 肝肿瘤 /
- 放射外科手术 /
- 治疗结果
Abstract: Objective To investigate the clinical effect and safety of Cyber Knife stereotactic radiosurgery in the treatment of small hepatocellular carcinoma ( s HCC) . Methods Twenty-eight patients with s HCC who underwent Cyber Knife radiosurgery in 302 hospital of PLA form March 2011 to December 2012 were enrolled. The total dose of Cyber Knife radiosurgery was 35-60 Gy in 3-5 fractions for 3-6 consecutive days. The median follow-up was 36 months. Modified Response Evaluation Criteria in Solid Tumors was used as assessment indices for short-term therapeutic effect, and the 1-, 2-, and 3-year overall survival rates and local control rates were used as assessment indices for long-term therapeutic effect. The Kaplan-Meier method was used to calculate cumulative survival rate and local control rate. Results Among the 28 patients, 17 achieved complete remission ( CR) , 8 achieved partial remission ( PR) , 2 achieved a stable disease, and1 had a progressive disease, resulting in a short-term response rate ( CR + PR) of 89. 28%. The 1-, 2-, and 3-year survival rates were 92. 86%, 85. 71%, and 78. 57%, respectively, and the 1-, 2-, and 3-year local control rates were 96. 43%, 92. 86%, and89. 28%, respectively. Toxic reactions were mainly grade 1 and 2 events. Conclusion Cyber Knife is a safe and effective option for s HCC and has the features of high local control rate, high survival rate, and few toxic reactions. Therefore, it can be used as an alternative treatment for patients with inoperable s HCC.
- hepatocellular carcinoma /
- radiosurgery /
- treatment outcome

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