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[目的]评价伽玛刀对原发性小肝癌的治疗疗效。[方法]2005年1月至2007年10月期间,无法行手术切除或拒绝手术切除的原发性小肝癌22例患者采用伽玛刀治疗。50%～70%等剂量曲线包绕PTV,(36～50)Gy/(8～12)f,(4～5)Gy/f,5f/w,平均照射剂量43.5Gy。用Kaplan-Meier分析生存率。[结果]CR4例(18.18%),PR12例(54.55%),SD4例(18.18%),PD2例(9.09%),总有效率为72.73%(16/22)。1、2、3年生存率分别为81.2%、68.7%和62.4%。中位生存时间40.0个月。治疗副反应轻微,无严重放射性肝损伤发生。[结论]伽玛刀对原发性小肝癌患者的治疗安全、有效,毒副反应较小,放射反应可耐受。
[Objective] To evaluate the therapeutic effect of gamma knife on primary small liver cancer. [Methods] From January 2005 to October 2007, 22 patients with primary small hepatocellular carcinoma who could not be surgically removed or refused surgery were treated with gamma knife. 50% ~ 70% isodose curve wrapped PTV, (36 ~ 50) Gy / (8 ~ 12) f, (4 ~ 5) Gy / f, 5f / w, the average dose of 43.5Gy. Survival rates were analyzed using Kaplan-Meier. [Results] The total effective rate was 72.73% (16/22) in CR4 cases (18.18%), PR12 cases (54.55%), SD4 cases (18.18%) and PD2 cases (9.09%). The 1, 2, 3 year survival rates were 81.2%, 68.7% and 62.4% respectively. The median survival time 40.0 months. Minor side effects of treatment, no serious radiation-induced liver injury. [Conclusion] Gamma Knife is safe and effective in the treatment of patients with primary small-cell carcinoma of the liver. The toxicity of the gamma-knife is small and the radiation response is tolerable.