摘要
目的评估基于风险调整剂量的立体定向放疗技术(SBRT)对结直肠癌单转移患者的治疗效果和不良反应。方法收集2013年2月至2016年3月南京市六合区人民医院确诊为结直肠癌单转移的患者,患者使用总剂量50~60 Gy/5次(60%等剂量线)、能够覆盖计划靶区的SBRT方案,在此期间未进行联合化疗(新辅助或辅助化疗除外)。对患者的临床资料、病情控制情况、生存率和不良反应等数据进行分析。结果共有60例患者74个转移病灶纳入研究,包括36例肝脏单转移和24例肺单转移。8例患者为初始治疗,52例患者为复发后使用SBRT治疗。中位随访时间为27.5(6.5~36.3)个月,第1、2年的局部控制率均为100.0%(95%CI=89.3%~100.0%),总生存率均为78.6%(95%CI=55.4%~91.9%),无病生存率分别为61.7%(95%CI=38.1%~80.8%)和55.4%(95%CI=31.7%~76.1%),无3级以上严重不良反应。结论基于风险调整剂量的SBRT技术有望成为结直肠癌单转移患者推荐疗法切除术联合化疗的替代方案,但其有效性还需更多前瞻性研究来验证。
Objective：To investigate the outcome and toxicities of patients with oligometastases from colorectal cancer treated by stereotactic body radiotherapy （SBRT） using risk-adapted dose prescription. Methods：Patients with oligometastases from colorectal cancer who were referred for SBRT from February 2013 to March 2016 in Liuhe District People’s Hospital of Nanjing were treated with a total dose of 50-60 Gy in five fractions prescribed to the 60% isodose line of the maximum dose. Concurrent chemotherapy was not admitted during SBRT, while neoadjuvant/adjuvant chemotherapy was allowed. The clinical data, disease control, survival rate and adverse reactions were analyzed. Results：A total of sixty patients with 74 metastatic lesions were brought into the study, including 36 patients with single hepatic metastasis and 24 with single lung metastasis. Eight patients were treated with SBRT as initial treatments, and 52 patients were treated after recurrent oligometastases. The median follow-up duration was 27.5 months （ranging for 6.5-36.3 months）. The local control rates for the first and second year were 100.0% （95% CI=89.3%-100.0%）, the overall survival rate was 78.6% （95% CI=55.4%-91.9%）, and the disease-free survival rates were 61.7% （95% CI=38.1%-80.8%） and 55.4% （95% CI=31.7%-76.1%）, respectively. There was no serious adverse events above grade 3 during follow-up. Conclusions：SBRT can provide an alternative to the surgical resection of oligometastases from colorectal cancer. However, more prospective studies are needed to validate its effectiveness.
出处
《中华普通外科学文献（电子版）》
2017年第5期305-309,共5页
Chinese Archives of General Surgery(Electronic Edition)
关键词
结直肠肿瘤
肿瘤转移
放射疗法
立体定向放疗
Colorectal neoplasms
Neoplasm metastasis
Radiotherapy
Stereotactic body radiotherapy
