摘要
通过对重离子治疗7例肝脏恶性肿瘤的初步临床结果总结,结合既往相关文献结果,评价肝脏恶性肿瘤行重离子治疗的有效性和安全性,为今后开展重离子治疗肝癌及肝转移癌提供一定的依据。纳入7例不能手术切除的肝脏恶性肿瘤患者,包括原发性肝癌3例和肝脏转移癌4例,进行定位,CT图像采集后,行靶区勾画和计划设计,计划完成并验证合格后于碳离子(400 MeV·u?1 12C6+)深部治疗终端实施治疗。治疗结束后随访期为3-16个月,随访率100%。治疗后3月评价近期疗效,客观缓解率(CR+PR)为57.1%,疾病控制率(CR+PR+SD)为100%。7例患者中除1例因特发性血小板较少而死亡外,尚无因肝脏疾病进展而死亡患者。患者总生存时间正在随访中。毒副反应方面,均无肝功能异常和放射性肝炎发生,仅有轻微胃肠道症状,无骨髓抑制发生。碳离子治疗肝脏恶性肿瘤近期疗效显著,安全性高,无明显毒副作用,可以作为无手术指征或不能耐受手术的肝脏原发及继发恶性肿瘤有效的局部治疗手段,但鉴于目前病例数少,随访时间短,其长期疗效尚需病例数的积累和长期的随访来进一步明确。
To evaluate the efficacy and safety of heavy ions （12C6＋） for hepatic malignance, we introduced unresectable hepatic malignance, including 3 patients with primary hepatic carcinoma and 4 with liver metastases. The patients were scanned for CT images, and delivered to treatment planning system for delineating the gross tumor volume （GTV）. And then the physicians designed the treatment plan. After completing and verifying the treatment plan, the patients were treated by radiotherapy in lanzhou heavy ion research facility using carbon ions （400 MeV.u-1 12C6＋）. As of September 2013 within 3 to 16 months, there were no patients lost to follow-up. After 3-month treatment, including PR 4 cases, SD 3 cases, the objective response rate （CR ＋ PR） turned to be 57.1%, and the disease control rate （CR ＋ PR ＋ SD） was 100%. Among the 7 patients, except for one died of idiopathic thrombocytopenic, the others survived with no progression of liver disease. Overall survival time was being followed up. In respect of toxicity, no liver function abnormalities and radioactive hepatitis occurred; The 7 patients had mild symptom of nausea, vomiting, fatigue, loss of appetite and other gastrointestinal symptoms but no myelosnppression. The preliminary clinical results show that heavy ion is an effective and safe treatment method with mild side effect for hepatic malignances. It＇s suitable for patients with unresectable primary and secondary liver malignancies or those cannot tolerate surgery. Given the current shortage of cases and follow-up time, its long-term efficacy requires more cases and longer follow-up time to clarify.
出处
《辐射研究与辐射工艺学报》
CAS
CSCD
2014年第1期14-21,共8页
Journal of Radiation Research and Radiation Processing
基金
甘肃省科技厅科技创新团队(09877CA009)资助
关键词
放射治疗
重离子
肝脏恶性肿瘤
Radiation therapy, Heavy ion, Hepatic malignance
