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目的探讨全身γ刀治疗原发性肝癌的疗效。方法 139例患者采用OUR-QGD型立体定向γ射线全身治疗系统(全身γ刀)治疗原发性肝癌,50%剂量线覆盖计划靶体积100%,处方剂量3～5Gy/次,隔日1次,总照射剂量36～50Gy。结果完全缓解率(CR)20.9%,部分缓解率(PR)48.9%,无变化(NC)15.8%,进展(PD)14.4%,总有效率为69.8%。1,2,3年总生存率分别为81.3%、62.5%和45.8%,Ⅲ期1,2年总生存率为52%和30.7%,Ⅳ期1,2年总生存率为31.3%和18.8%。结论全身γ刀治疗原发性肝癌安全有效,对早期及Ⅲ期肝癌可提高局控率和生存率,对部分晚期患者,可缓解症状,提高生活质量。
Objective To investigate the curative effect of whole body gamma knife in the treatment of primary liver cancer. Methods One hundred and ninety-three patients were treated with OUR-QGD stereotactic gamma-ray system (whole body gamma knife) for primary hepatocellular carcinoma. The target dose of 50% dose line covered 100% of target volume, prescription dose was 3-5 Gy, once every other day, The total exposure dose 36 ~ 50Gy. Results Complete response rate (CR) was 20.9%, partial response rate (PR) was 48.9%, no change (NC) was 15.8%, progress (PD) was 14.4%, and total effective rate was 69.8%. The overall survival rates at 1, 2 and 3 years were 81.3%, 62.5% and 45.8%, respectively. The overall survival rates at 1 and 2 years of stage Ⅲ were 52% and 30.7%, respectively. The overall survival rates at 1 and 2 years of stage Ⅳ were 31.3% and 18.8% %. Conclusion The whole body gamma knife treatment of primary liver cancer safe and effective on early and stage Ⅲ HCC can improve the control rate and survival rate, for some patients with advanced stage, can relieve symptoms and improve quality of life.