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目的评价小肝癌(s HCC)患者接受射波刀立体定向放射外科治疗的疗效和安全性。方法收集2011年3月-2012年12月解放军第三○二医院行射波刀治疗的28例s HCC患者。射波刀治疗总剂量35~60 Gy/3~5次,连续治疗3~6 d。中位随访时间36个月。依据改良版实体瘤疗效评价标准(mRECIST)进行近期疗效评价,以1、2、3年总生存率和局部控制率作为远期疗效评价指标。采用Kaplan-Meier法分析计算累积生存率和局部控制率。结果 28例患者中,完全缓解17例,部分缓解8例,稳定2例,疾病进展1例,近期有效率89.28%。1、2、3年生存率分别为92.86%、85.71%和78.57%;1、2、3年局部控制率分别为96.43%、92.86%和89.28%。毒性反应主要表现为Ⅰ~Ⅱ级事件。结论射波刀治疗s HCC是安全、有效的,具有较高的局部控制率、生存率和低毒性反应,可以作为不适合手术治疗的s HCC的替代治疗。
Objective To evaluate the efficacy and safety of radiosurgery for stereotactic radiosurgery in patients with small hepatocellular carcinoma (s HCC). Methods Twenty-eight patients with s-HCC treated with radiosurgery at the 302 Hospital of PLA from March 2011 to December 2012 were collected. The total dose of radiotherapy knife 35 ~ 60 Gy / 3 ~ 5 times, continuous treatment of 3 ~ 6 d. The median follow-up time was 36 months. According to the modified solid tumor efficacy evaluation criteria (mRECIST) for short-term efficacy evaluation, 1, 2, 3-year overall survival rate and local control rate as a long-term efficacy evaluation index. Kaplan-Meier analysis was used to calculate the cumulative survival rate and local control rate. Results Of the 28 patients, complete remission was achieved in 17 cases, partial remission in 8 cases, stable in 2 cases, disease progression in 1 case, and immediate success rate of 89.28%. The 1-year, 2-year and 3-year survival rates were 92.86%, 85.71% and 78.57% respectively. The local control rates at 1, 2 and 3 years were 96.43%, 92.86% and 89.28% respectively. Toxicity mainly manifested as Ⅰ ~ Ⅱ level events. Conclusion sHCC is a safe and effective treatment for sHCC with high local control rate, survival rate and low toxicity. It can be used as an alternative treatment for s HCC that is not suitable for surgical treatment.