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目的:探讨体部伽玛刀治疗膀胱癌的临床疗效及毒副反应。方法:采用OUR-QGD体部伽玛刀治疗膀胱癌患者40例,根据病灶的三维形状及患者身体状况确定靶点数目、治疗次数及分次剂量。单次治疗剂量为3.0～4.0Gy,等剂量曲线为50.0%～65.0%,计划靶体积(PTV)覆盖>95.0%临床靶体积(CTV),共计10～12次。根据患者年龄、KPS评分、肿瘤侵及范围、CTV、治疗毒副反应调整治疗剂量。随访6～36个月,平均18个月。结果:所有患者治疗后3个月复查,并进行疗效评价,其中完全缓解13例,部分缓解24例,稳定3例,近期有效率为92.5%(37/40),1年生存率90.0%(36/40)。治疗中与治疗后发生的副反应及放射性损伤均较小。结论:体部伽玛刀是对膀胱癌比较有效的治疗方法,毒副反应较轻,临床应用安全。
Objective: To investigate the clinical efficacy and side effects of gamma knife in treating bladder cancer. Methods: OUR-QGD Gamma Knife was used to treat 40 cases of bladder cancer. According to the three-dimensional shape of the lesion and the physical condition of the patient, the number of targets, the number of treatments and the divided doses were determined. The single treatment dose was 3.0-4.0 Gy, the isodose curve was 50.0-65.0%, and the planned target volume (PTV) covered> 95.0% of the clinical target volume (CTV) for a total of 10-12 sessions. The therapeutic dose was adjusted according to patient’s age, KPS score, tumor invasion range, CTV, and treatment side effects. Follow-up 6 to 36 months, an average of 18 months. Results: All patients were reviewed 3 months after treatment and evaluated. The complete remission was achieved in 13 cases, partial remission in 24 cases and stable in 3 cases. The effective rate was 92.5% (37/40) and the 1-year survival rate was 90.0% 36/40). Side effects and radioactive damage occurred during and after treatment were small. Conclusion: Gamma Knife is a more effective treatment for bladder cancer with less toxic side effects and clinical application.