本文選題：肝腫瘤　切入點：放射療法　出處：《腫瘤》2017年04期

【摘要】：目的:評價基于螺旋斷層放療技術(shù)的立體定向放療(stereotactic body radiation therapy,SBRT)在治療肝細胞肝癌中的療效及不良反應(yīng)。方法:收集復(fù)旦大學(xué)附屬中山醫(yī)院腫瘤放療科2012年12月—2015年12月收治的46例肝細胞肝癌患者的臨床病理資料和隨訪資料。所有患者均采用基于螺旋斷層放療技術(shù)的SBRT治療。腫瘤平均直徑為2.5 cm(范圍:0.9~5.8 cm),采用四維CT(four-dimensional CT,4-DCT)的定位方法。治療前行圖像引導(dǎo)下的匹配校準,總照射劑量為48~50 Gy,分割次數(shù)為5~10次,SBRT治療期間給予保肝和營養(yǎng)支持等對癥支持治療。治療6個月后采用改良實體瘤療效評價標準(modified response evaluation criteria in solid tumors,mRECIST)行療效評價;不良反應(yīng)評價采用美國國立癌癥研究所事件通用術(shù)語標準3.0(National Cancer Institute-Common Terminology Criteria for Adverse Events 3.0,NCI-CTC 3.0);生存分析用Kaplan-Meier法。結(jié)果:所有患者均完成治療,治療后每隔3個月隨訪1次,其中完全緩解(complete remmision,CR)27例(58.7%),部分緩解(partial response,PR)15例(32.6%),病情穩(wěn)定(stable disease,SD)2例(4.3%),疾病進展(progressive disease,PD)2例(4.3%),總有效率(CR+PR)為91.3%。自放療之日開始計算生存率,46例患者的1年、2年和3年的生存率分別為95.4%、75.7%和69.9%。不良反應(yīng)方面,僅有5例出現(xiàn)Ⅰ度骨髓抑制,2例出現(xiàn)Ⅱ度骨髓抑制,2例出現(xiàn)Ⅰ度轉(zhuǎn)氨酶升高。結(jié)論:采用螺旋斷層放療是一種安全、有效的治療手段。對于那些無法手術(shù)或射頻消融的肝細胞肝癌患者,SBRT是一種行之有效的方法,值得進一步推廣。
[Abstract]:Objective: to evaluate the efficacy and side effects of stereotactic body radiation therapy based on spiral tomography in the treatment of hepatocellular carcinoma. Methods: from December 2012 to 2015, the Department of Oncology, Zhongshan Hospital affiliated to Fudan University was collected. The clinicopathological data and follow-up data of 46 patients with hepatocellular carcinoma treated in December. All patients were treated with SBRT based on helical tomography. The mean diameter of the tumor was 2.5 cm (range: 0.95.8cm / cm), and the tumor was determined by four-dimensional CT(four-dimensional CT4-DCT. Image matching and calibration before treatment, The total irradiation dose was 48g / 50 Gy, and the number of fractions was 5g / 10. The therapeutic effect was evaluated by modified response evaluation criteria in solid tumor RECIST (modified response evaluation criteria in solid RECIST) after 6 months of treatment. Adverse reactions were evaluated by 3.0(National Cancer Institute-Common Terminology Criteria for Adverse Events 3.0 and survival analysis by Kaplan-Meier. Results: all patients were treated and followed up every 3 months after treatment. There were 27 cases of complete remission, 15 cases of partial response, 15 cases of partial response, 2 cases of stable disease, 2 cases of progressive disease and 2 cases of progressive disease. The total effective rate was 91.3%. The survival rate of 46 patients was calculated from the day of radiotherapy. The adverse reactions were 95.4% and 69.9%, respectively. There were only 5 cases of grade 鈪，

本文編號：1666570