Evaluation of the Efficacy of Three Dimensional Conformal Radiation Therapy on Primary Liver Cancer
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摘要: 目的:探讨三维适形放射治疗原发性肝癌的疗效及放疗反应。方法:从1997年3月到2000年10月,用三维适形放射治疗的方法治疗原发性肝癌患者89例,肿瘤体积36～492cm3,用Elekta公司的TPS设计治疗计划,并根据DVH图进行计划优化。治疗采用6MV-X线,处方剂量4～5Gy/次,隔日照射一次,5～6个共面或非共面野进行适形照射,共治疗8～10次,总剂量40Gy,整个疗程16～20天。近期疗效按WHO实体肿瘤疗效标准评价,正常组织的放射反应按RTOG标准评价。结果:近期疗效:放疗结束后三个月,完全缓解率(CR)为29.2%(26/89),部分缓解率(PR)为49.4%(44/89),总有效率(PR+CR)为78.7%。1、2、3年生存率分别为64.0%(57/89)、41.6%(37/89)和28.1%(25/89)。肿瘤体积越小,疗效越好(P=0.005)。放疗反应主要为消化道反应和肝脏放射性损伤,肝脏的放射性损伤和受照射体积有关。结论:三维适形放射治疗原发性肝癌有较好的疗效,放射反应可以耐受。Abstract: Objective: To explore the result and side effect of the 3 dimensional conformal radia-tion therapy (3DCRT) for primary liver cancer.Methods: From Mar. 1997 to Oct. 2000, 89 patientswith primary liver cancer were treated with 3DCRT. Radiotherapy was designed by 3- D treatment plansystem of the Elekta company. Dose volume histography (DVH) was used to verify and optimize the ra-dio- therapeutic regimen. The total dose was 40 Gy and it was delivered 4-5Gy per fraction, once everyother day, with total 8-10 fractions during 16-20 days, using 5-6 coplane or non- coplane for conformalirradiation. The immediate response and side effect were evaluated based on the WHO and RTOG cri-terion system.Results: Three months after irradiation, the overall immediate response rate (CR+PR)was 78.7%. The 1-, 2-and 3-year survival rate were 64.0%(57/89), 41.6%(37/89) and 28.1%(25/89),respectively. The immediate response was related to the target volume. The smaller the targeted volume,the better the response (χ2=18.428, P=0.005). The side effect of acute irradiation was mainly digestivetract effect and radiation-induced liver injury. The radiation- induced liver injury was also related tothe radiated volume of the liver.Conclusions: Three dimensional conformal radiotherapy can be con-sidered as an effective and feasible approach for primary liver cancer, with no any serious complica-tions.
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Keywords:
- Liver neoplasm/radiotherapy /
- Liver neoplasm /
- Radiotherapy /
- Conformal
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