摘要
目的评价使用全身伽玛射线立体定向放射治疗在结直肠癌单发肝转移中的疗效及其放射反应。方法收集我科2007年1月至2012年12月收治的结直肠癌单发肝转移病患28例,使用全身伽玛射线立体定向放射治疗系统进行治疗。对患者进行密切随访,评价患者近期疗效,观察其6、12和18个月(或随访至患者死亡)生存率和中位生存期。结果全部28例病患均随访18个月以上(或随访至患者死亡),6、12和18个月生存率分别为79%(22/28)、64%(18/28)、46%(13/28),病例中生存超过3年的有4例。治疗前10例患者血AFP>400 ng/m L,最高≥61 000 ng/m L,平均约为1 800 ng/m L;治疗3个月后,8例患者血AFP有不同程度降低,其中5例恢复正常。治疗前20例患者血CEA异常升高;治疗3个月后,有18例患者血CEA出现不同程度下降,其中10例恢复正常。治疗过程中发生的放疗反应主要为早期放疗反应,其中15例出现一般性全身反应(表现为乏力、纳差、恶心、呕吐),2例出现放射性胃溃疡,经对症治疗后均缓解,未发现有其他严重副反应。结论采用全身伽玛射线立体定向放射治疗系统治疗单发结直肠癌肝转移有近期疗效好、放射反应轻特点,但其晚期放射损伤及远期疗效仍有待进一步观察评价。
Objective To evaluate the efficacy and the radiation reactions of gamma stereotactic body radiotherapy in the treatment of patients with colorectal cancer complicating single-shot liver metastasis. Methods Twenty-eight patients with colorectal cancer complicating single-shot liver metastasis admitted to our hospital from January 2007 to December 2012 were selected and treated with gamma stereotactic body radiotherapy. All patients were followed up until the death of them, the short-term effects were evaluated and the survival rate and average survival period at 6 months, 12 months and 18 months were observed. Results 28 patients were followed up for 18 months or more,and the survival rate at 6 months, 12 months and 18 months were 79%, 64% and 46% respectively, and 4 patients survived over 3 years.Before treatment, the serum AFP of 10 patients was over 400 ng/m L, the highest AFP was 61 000 ng/m L, the average AFP was 1 800 ng/m L;3 months after treatment, the serum AFP of 8 patients was decreased, with 5 cases declined to normal range. Before treatment, the serum CEA of 20 patients was abnormally increased; 3 months after treatment, the serum of 18 patients was decreased, with 10 cases decreased to normal range. The main radiation reaction was early adverse reaction, including general reactions（fatigue, loss appetite, nausea and vomiting） in 15 cases, radioactive ulcer in 2 cases, and all of them were relieved after expectant treatment, no other severe adverse events were found. Conclusions Gamma stereotactic body radiotherapy has good short-term efficacy and moderate radiate reactions in treating colorectal cancer complicating single-shot liver metastasis lesion, but the long-term efficacy and late radiation damage need further study.
出处
《临床医学工程》
2015年第6期726-727,730,共3页
Clinical Medicine & Engineering
关键词
结直肠癌
肝转移癌
立体定向放射治疗
Colorectal cancer
Liver metastasis
Stereotactic radiotherapy
