【摘要】：目的:收集行體部伽瑪?shù)吨委熢l(fā)性肝癌患者的臨床資料,分析其治療方案及近期療效,為原發(fā)性肝癌患者的臨床治療提供參考依據(jù)。方法:選擇633例無(wú)法行手術(shù)治療的原發(fā)性肝癌患者行伽瑪?shù)吨委?按照國(guó)際抗癌聯(lián)盟(UICC)公布的TNM分期方法,有明確TNM分期的患者351例,其中T3期患者251例(71.5%,251/351),T4期患者57例(16.2%,57/351)。每次分割劑量為200~600cGy,照射次數(shù)為2~13次,每日或隔日照射,每周5次,40%~85%等劑量曲線覆蓋計(jì)劃靶區(qū)(PTV)。治療結(jié)束后2~3個(gè)月45例患者行影像學(xué)及腫瘤標(biāo)志物等復(fù)查,觀察腫瘤直徑變化情況,評(píng)價(jià)其近期療效。結(jié)果:伽瑪?shù)吨委熎陂g,229例(36.2%)患者發(fā)生了不良反應(yīng),100例(15.8%)患者出現(xiàn)白細(xì)胞降低,137例(21.6%)患者出現(xiàn)血小板降低。出院時(shí)601例患者病情好轉(zhuǎn),22例無(wú)明顯變化,5例病情加重,5例死亡。接受累積劑量為3 000cGy~和3 500cGy~組患者癥狀好轉(zhuǎn)比例均高于累積劑量3 000cGy組(P0.05)。45例出院患者隨訪,2~3個(gè)月的部分緩解(PR)患者占80%(36/45),穩(wěn)定(SD)患者占20%(9/45),總有效率為80%(36/45)。不同腫瘤直徑、單次劑量和累積劑量組有效率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:體部伽瑪?shù)吨委熢l(fā)性肝癌患者不良反應(yīng)發(fā)生的比例較低,近期有效率較為理想;體部伽瑪?shù)吨委熢l(fā)性肝癌患者是一種安全有效的治療方法。
[Abstract]:Objective: to collect the clinical data of patients with primary liver cancer treated with body gamma knife, and to analyze its treatment scheme and short-term curative effect, and to provide reference for clinical treatment of patients with primary liver cancer. Methods: a total of 633 patients with primary liver cancer who could not be treated by operation were treated with gamma knife. According to the TNM staging method published by (UICC), 351 patients with definite TNM staging were selected, among whom 251 patients with T3 stage (71.5 / 251 / 351) and 57 patients with T4 stage (16.2 / 351). Each partition dose is 200,600cGy, the radiation frequency is 2t 13 times, daily or every other day, 5 times a week, 40% 85% isodose curve covers the planned target area (PTV). From 2 to 3 months after treatment, 45 patients were examined with imaging and tumor markers to observe the change of tumor diameter and evaluate the short-term curative effect. Results: during the period of gamma knife therapy, 229 (36.2%) patients had adverse reactions, 100 (15.8%) patients had leukopenia and 137 (21.6%) patients had thrombocytopenia. At the time of discharge, 601 patients had improved and 22 patients had no obvious change. 5 cases had aggravation and 5 cases died. The rate of symptom improvement in the cumulative dose of 3 000 cGy ~ and 3 500 cGy ~ was higher than that in the cumulative dose 3 000cGy group (P0.05) .45 patients who were followed up for 2 ~ 3 months accounted for 80% (36 / 45) of partial remission (PR) and 20% (9 / 45) of stable (SD). The total effective rate was 80% (36 / 45). There was no significant difference in effective rate between different tumor diameter, single dose and cumulative dose group (P0.05). Conclusion: the rate of adverse reactions in patients with primary liver cancer treated by body gamma knife is low, and the short-term effective rate is ideal, which is a safe and effective treatment method for patients with primary liver cancer.
【作者單位】： 吉林大學(xué)公共衛(wèi)生學(xué)院流行病與衛(wèi)生統(tǒng)計(jì)學(xué)教研室;武警上海市總隊(duì)醫(yī)院腫瘤放射診療中心;廣東省深圳市海博科技有限公司;西藏自治區(qū)昌都惠恒發(fā)展有限公司;
【基金】：吉林省衛(wèi)計(jì)委科研基金資助課題(20165044)
【分類號(hào)】：R735.7

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