当前位置: 首页 > 期刊 > 《中华实用医药杂志》 > 2006年第12期
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X线立体定向放射治疗转移性肝癌
http://www.100md.com 《中华实用医药杂志》 2006年第12期
转移性肝癌;X线立体定向;三维重建,,转移性肝癌;X线立体定向;三维重建,1资料与方法,2结果,3讨论,【参考文献】
     【摘要】 目的 报告60例转移性肝癌X线立体定向放射治疗(X-SRT)后的临床及影像学变化,讨论X-SRT对转移性肝癌的治疗作用。方法 自1998年10月~2003年10月,利用CRT-98立体定向放射治疗系统治疗60例肝转移癌患者,根据肿瘤的位置、临床靶体积、患者的身体状况与治疗目的,制定放射治疗计划及调整剂量分布,采用多角度、非共面等中心旋转照射。单靶点X-SRT治疗13例,多靶点X-SRT治疗47例,每次分割剂量4~8Gy,照射6~12次,每周3次,隔日1次,1个中心参考剂量线定在90%,2个中心参考剂量线定在50%~80%,肿瘤剂量42~48Gy。结果 全组60例获得8~48个月的随访,中位13个月。1、2和3年生存率分别为53.3%、28.3%和13.3%。在治疗后6个月CT或MRI复查18例病灶消失占30%,24例病灶缩小占40%,9例出现新的转移灶占15%;9例因合并其他转移而死亡。结论 X线立体定向放射治疗肝转移癌,能够对肿瘤提供较高的治疗剂量,改善并提高此类患者的肿瘤控制率及生存率的机会。

    【关键词】 转移性肝癌;X线立体定向;三维重建

    X-ray stereotactic radiotherapy for metastasis liver carcinoma

    HAO Chuan-guo,WEI Lin.Radiotherapy Center of Taian City,Central Hospital,Shandong 271000,China

    【Abstract】 Objective 60 cases of liver metastatic cancer who were treated with X-ray stereotactic radiotherapy.The clinical and image changes were analyzed.To discuss the treatment effect of the X-ray stereotactic radiotherapy.Methods From October 1998 to October 2003,60 patients with metastasis liver tumor were treated with SRT.Radiotherapeutic plan was worked out and dosage distribution were set on the basis of the carcinoma position,clinical target volume,health condition of patients and therapeutic aim.The treatment was performed using 4 to 6 arcs delivering with noncoplanar isocenter beams. 13 patients treated with one target,47 patients treated with multi-targets.60 patients who were treaded with SRT received a mean dose of 54.7±6Gy with a 4~8Gy/f,3f/w,qod regimen,the dose were divided 6~12times.Reference dose was defined with 90% isodose covering the target in patients using one center and 50%~80% in patients using multi-centers.The total dose of tumor is 42~48Gy.Results The follow-time of patients lasting range from 8 to 48 months,median 13 months.The 1、2 and 3 year survival rate was 53.3%,28.3%,and 13.3%,respectively.After 6 months examined by CT or MRI.The focuses of 18 cases had been clear shrink or disappear were 30%,24 cases had been focuses were 40%.9 cases had been find new metastased focuses were 15%;9 cases were died combined with distance metastases.Conclusion The X-ray stereotactic radiotherapy is able to improve more treat dose and the local control of tumor,prolong the survival of patients with metastasis liver tumor. ......

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