体部立体定向放射治疗肝转移瘤22例临床疗效

目的 分析大分割体部立体定向放射治疗肝转移瘤的临床疗效和副反应.方法 回顾性分析2007年前10年内22例不可手术且化疗失败的肝转移瘤患者,共33个病灶接受大分割体部立体定向放射治疗.最常见的原发灶部位分别为乳腺12例和结直肠5例.单纯肝转移患者15例(68%),伴有其他部位转移患者7例(32%).中位病灶最大径2.0 cm(1.0～4.3 cm),中位靶体积3.68 cm~3(0.45～77.29 cm~3).接受一程治疗18例,二程治疗4例.中位总剂量40 Gy(30～60 Gy),中位分割次数为3次(2～6次).结果 中位随访时间13.9个月(5.0～36.4个月),随访率100%.中位生存时间为13.9个月.1、2年局部控制率分别为100%、90%.1、2年总生存率分别为73%、49%,1、2年无疾病进展生存率分别为94%、28%.所有患者均能耐受,无3级以上相关并发症.结论 大分割体部立体定向放射治疗对肝转移瘤是安全有效的,局部控制率高且并发症可接受.

Fractionated stereotactic body radiotherapy for 22 patients with liver metastatses

Objective To evaluate the efficacy and toxicity of fractionated stereotactic body radiotherapy in treating patients with liver metastases. Methods From January 1997 to January 2007, 22 patients with liver metastases of total 33 lesions were treated with fractionated stereotactic body radiation therapy (SBRT). All patients were confirmed as unresectable and resistant to chemotherapy. The most common primaries were breast cancer in 12 patients and colorectal cancer in 5. Fifteen patients had metastases in the liver alone and 7 had concurrent metastases in other sites. Eighteen patients received one course of SBRT, and 4 patients got two courses. The median total dose was 40 (range, 30 - 60) Gy in 3 (range, 2 -6) fractions. Results All patients were followed up. The median follow up was 13.9 months (range, 5.0 -36. 4 months). The median size of the irradiated lesions was 2. 0 cm (range 1.0 -4. 3 cm) and the target volume was 3. 68 cm~3 (range 0. 45 - 77. 29 cm~3). The 1- and 2-year local control rate, overall survival rate and progression-free survival rate were 100% and 90%, 73% and 49%, 94% and 28%, respectively. No grade 3/4 SBRT related toxicities occurred. Conclusions SBRT, with high local control and tolerable complications, is an effective and safe treatment for liver metastases.