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目的 :探讨体部伽马刀治疗结肠癌患者肝肺转移灶的临床疗效。方法 :选取2009年1月~2011年1月解放军第105医院收治的58例发生肝肺转移的结肠癌患者,随机将其分成对照组和观察组,其中对照组28例共113个转移灶,采用单纯全身化疗治疗,观察组30例共116个转移灶,采用体部伽马刀治疗。治疗结束后比较两组患者的近期疗效,1年、2年和3年局控率和生存率、血清癌胚抗原(carcino-embryonic antigen,CEA)的变化情况以及两组患者的不良反应情况。结果:观察组患者总缓解率(84.5%)明显高于对照组患者(49.6%)(P<0.05);观察组患者治疗后血清CEA浓度(3.8±1.3)ng/m L明显低于对照组患者(7.3±3.2)ng/m L(P<0.05);观察组患者的1年(96.7%)、2年(90.0%)、3年(86.7%)局控率明显高于对照组患者(85.7%、64.3%和35.7%,P<0.05);观察组患者的1年(73.3%)、2年(36.7%)、3年(20.0%)生存率明显高于对照组患者(64.3%,28.6%和7.1%,P<0.05);观察组患者消化道反应、血液学毒性以及肝肾毒性发生率(20.0%、13.3%和6.7%)明显低于对照组患者(64.3%、50.0%和35.7%,P<0.05)。结论:体部伽马刀治疗结肠癌患者肝肺转移灶临床疗效显著,安全有效,值得临床推广应用。
Objective: To investigate the clinical effect of gamma knife on liver and lung metastasis in patients with colon cancer. Methods: From January 2009 to January 2011, 105 cases of colon cancer patients with liver-lung metastasis admitted to the 105th Hospital of People’s Liberation Army were randomly divided into control group and observation group, of which 28 cases in control group had 113 metastases, Using simple systemic chemotherapy, the observation group of 30 patients with a total of 116 metastases, the use of body gamma knife treatment. After treatment, the short-term curative effect, 1-year, 2-year and 3-year local control rate and survival rate, carcinoembryonic antigen (CEA) and the adverse reactions of two groups were compared. Results: The total response rate (84.5%) in the observation group was significantly higher than that in the control group (49.6%) (P <0.05). The CEA concentration in the observation group was significantly lower than that in the control group (3.8 ± 1.3) ng / m L (7.3 ± 3.2) ng / m L (P <0.05). The local control rate in one year (96.7%), two years (90.0%) and three years (86.7%) in the observation group was significantly higher than that in the control group 85.7%, 64.3% and 35.7%, respectively; P <0.05). The survival rate of patients in the observation group was significantly higher than that of the control group in one year (73.3%), 2 years (36.7% 28.6% and 7.1%, P <0.05). The incidences of digestive tract reaction, hematological toxicity and hepatorenal toxicity (20.0%, 13.3% and 6.7%) in the observation group were significantly lower than those in the control group (64.3% and 50.0% 35.7%, P <0.05). Conclusion: Gamma knife treatment of colorectal cancer patients with liver and lung metastasis clinical significant effect, safe and effective, worthy of clinical application.