摘要
目的评价射波刀SBRT在复发性胆管细胞癌治疗中的效果及安全性。方法回顾分析2010-2015年26例术后复发的胆管癌射波刀SBRT的患者,中位术后复发时间10个月,中位肿瘤直径为2.8cm。中位处方剂量45Gy,中位分割次数5次。基于增强CT或MRI评估肿瘤进展。采用Kaplan-Meier法计算OS、PFS及LC。使用CTCAE4.0版评估不良反应。结果中位随访29.3个月,其中位OS和PFS分别为13.5个月和6.5个月,1、2年OS和PFS率分别为52%、21%和28%、15%。4例患者出现肿瘤原位进展。3例患者发生3级不良反应,包括1例胃肠道反应、1例肝功能减退、1例胆道感染;仅1例患者在晚期出现了≥4级消化道出血。结论射波刀SBRT术后复发性胆管癌可获得较好的疗效且不良反应可耐受。
Objective To evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using Cyberknife in the treatment of patients with recurrent cholangiocellular carcinoma (RCC) after surgery. Methods Clinical data of 26 patients with recurrent RCC after surgery undergoing Cyberknife SBRT from 2010 to 2015 were retrospectively analyzed. The median recurrence time was 10 months (range 2.0-63.0 months) and the median tumor diameter was 2.8 cm (range 1.2-4.8 cm). The median prescription dose/fraction was 45 Gy/5f (range 40-50 Gy/3-8 f). The tumor progression was evaluated based on enhanced CT or MRI. Overall survival (OS), progression-free survival (PFS) and local control rate (LC) were analyzed by Kaplan-Meier method. Toxicity was assessed using the common terminology criteria for adverse events version 4.0. Results For the entire cohort, the median OS and PFS were 13.5 months and 6.5 months at a median follow-up of 29.3 months (range 2.1-62.0 months). The 1-and 2-year OS and PFS rates were 52% and 21% as well as 28% and 15%, respectively. Among them, 4 patients (4/26, 15%) were recurrent in situ after SBRT. Three patients experienced grade Ⅲ adverse reactions including 1 case of gastrointestinal reaction, 1 case of liver dysfunction and 1 case of biliary tract infection. Only 1 patient suffered from ≥grade IV gastrointestinal bleeding during the advanced stage. Conclusions SBRT using Cyberknife is a safe and effective treatment for patients with recurrent RCC after surgery. The adverse reactions can be tolerated by patients.
作者
刘壮
邱鸣寒
吴志强
孟茂斌
王欢欢
王中秋
董洋
袁智勇
王平
Liu Zhuang;Qiu Minghan;Wu Zhiqiang;Meng Maobin;Wang Huanhuan;Wang Zhongqiu;Dong Yang;Yuan Zhiyong;Wang Ping(Department of Radiation Oncology,Cancer Hospital,Tianjin Medical University,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy of Tianjin,Tianjin′s Clinical Research Center for Cancer,Tianjin 300060,China;Tianjin People′s Hospital Cancer Center,Third Department of Cancer Therapy,Tianjin 300121,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2019年第7期518-521,共4页
Chinese Journal of Radiation Oncology
基金
国家自然科学基金(81472797).
关键词
胆管细胞癌/立体定向放射疗法
射波刀
治疗结果
Cholangiocellular neoplasm/stereotactic body radiotherapy
Cyberknife
Treatment outcome
