论文部分内容阅读
目的:探讨体部伽玛刀治疗原发性肝癌伴门静脉癌栓(portal vein tumor thrombosis,PVTT)的临床疗效。方法:在64例经CT/MR证实伴有PVTT的肝癌患者中,28例未接受任何治疗,36例针对癌栓行伽玛射线立体定向放疗,以50%~70%等剂量曲线覆盖靶区边缘,分割照射剂量3~5 Gy/次,5次/周,共治疗10次,总照射剂量30~50 Gy。并随访观察其近期疗效及生存率。结果:伽玛刀治疗组癌栓治疗有效率(objective response rate,ORR)为63.9%,其中完全缓解(complete response,CR)9例(25%),部分缓解(partial response,PR)14例(38.9%),疾病稳定(stable disease,SD)6例(16.7%),疾病进展(progressive disease,PD)7例(19.4%)。患者1年生存率为36.1%,2年生存率为8.3%,中位生存期为10个月。而未治疗组病灶稳定3例(10.7%),进展25例(89.3%),1年和2年生存率均为0,中位生存期为3个月。结论:伽玛刀治疗原发性肝癌伴PVTT安全有效、毒副反应轻,能延长患者生存期。
Objective: To investigate the clinical efficacy of gamma knife in the treatment of primary liver cancer with portal vein tumor thrombosis (PVTT). Methods: Of the 64 patients with hepatocellular carcinoma confirmed by CT / MR with PVTT, 28 patients received no treatment and 36 patients received thrombus embolization with gamma-ray stereotactic radiotherapy. The target area was covered by 50% -70% isodose curve Edge, split the dose of irradiation 3 ~ 5 Gy / time, 5 times / week, a total of 10 times the total exposure dose of 30 ~ 50 Gy. Follow-up observation of its short-term efficacy and survival rate. Results: The objective response rate (ORR) of gamma knife treatment group was 63.9%, of which 9 cases (25%) had complete response (CR), 14 cases partial response (PR) 38.9%), stable disease (SD) in 6 cases (16.7%) and progressive disease (PD) in 7 cases (19.4%). The 1-year survival rate was 36.1%, the 2-year survival rate was 8.3%, and the median survival time was 10 months. In the untreated group, the lesions were stable in 3 cases (10.7%), progression was 25 cases (89.3%), the 1-year and 2-year survival rates were 0, and the median survival time was 3 months. Conclusion: Gamma knife treatment of primary liver cancer with PVTT safe and effective, light side effects, can extend the survival of patients.