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目的观察评价体部伽玛刀治疗原发性肝癌的临床疗效和放射反应。方法采用体部伽玛刀治疗原发性肝癌98例,用真空负压袋固定体位、CT定位扫描和三维计划。根据肿瘤位置、肿瘤体积、患者的身体状况与治疗目的,制定治疗计划及调整剂量线分布,确定总剂量及分割剂量。50%～70%的等剂量线覆盖95%以上的计划靶体积、100%的肿瘤体积,3～5 Gy/次,5次/周,总剂量36～50 Gy。结果 8例患者治疗后3个月内死亡,未作疗效评价。治疗后3～4个月复查CT或MRI,肝内病灶CR 25.6%(23/90),PR 53.3%(48/90),NC 17.8%(16/90),PD 3.3%(3/90),总有效率78.9%,半年局部无进展生存率72.2%,1年局部无进展生存率22.2%,1年生存率62.2%。无消化道大出血、穿孔等严重放射反应。结论体部伽玛刀治疗原发性肝癌近期疗效肯定,是一种有效的局部治疗方法。
Objective To evaluate the clinical efficacy and radiation response of body gamma knife in the treatment of primary liver cancer. Methods Ninety-four cases of primary liver cancer were treated with Gamma Knife. Vacuum vacuum bag was used to fix the position, CT scan and 3D plan. According to the tumor location, tumor volume, the patient’s physical condition and treatment purposes, to develop treatment plans and adjust the dose line distribution, determine the total dose and divided doses. 50% to 70% of the isodose lines cover more than 95% of the planned target volume, 100% of the tumor volume, 3-5 Gy / time, 5 times / week, and a total dose of 36-50 Gy. Results 8 patients died within 3 months after treatment, no evaluation of the curative effect. The CT or MRI were reviewed 3 to 4 months after treatment. The intrahepatic lesions were CR 25.6% (23/90), PR 53.3% (48/90), NC 17.8% (16/90), PD 3.3% (3/90) , With a total effective rate of 78.9%, a half-year local progression-free survival rate of 72.2%, a 1-year local progression-free survival rate of 22.2% and a 1-year survival rate of 62.2%. No gastrointestinal bleeding, perforation and other serious radiation reactions. Conclusion Gamma Knife for the treatment of primary liver cancer has a positive effect, is an effective method of local treatment.