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ID:54708150
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时间:2020-05-04
《或下腔静脉癌栓临床观察-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、·1130·杨远游,等伽马刀治疗3l例原发性肝癌门脉和/或下腔静脉癌栓临床观察伽马刀治疗31例原发性肝癌门脉和/或下腔静脉癌栓临床观察杨远游,程海明,穆晓峰,宁健Gamma—-knifetreatmenton31patientswithprimarylivercancerwithpoMaland/orin-feriorvenacavafumorfhrombusYangYuanyou,ChengHaiming,MuXiaofeng,NingJianCancerRadiotherapyCenter,ArmedPoliceGeneralHospital,Beijing100039,Chin
2、a.【Abstract】0bjective:ToanalyzetheeffectivenessandprognosticfactorofGamma—knifetreatmentonprimarylivercancerportalveinand/orinferiorvenacavatumorthrombus.Methods:2006to2012inourhospital31casesofprimarylivercancerportalveinthrombosisand/orinferiorvenacavatumorthrombuspatientsweretreatedbysuperGa
3、mma—knifetoperformstereotacticradiotherapy.Prescriptiondoseto40%一60%isodoseline.A44Gytotalmedi—andose(rang:32—52Gy)wereprescribedtothe40%一60%isodoselineandin8—13fractionof3.5—5Gyeachforclinicaltargetvolume.Theclinicaltargetvolumeincludedtumorthrombuswithorwithouttheprimarylesionofliv—er.Attheen
4、doftreatment,bloodcount,bloodchemistry,tumormarkersandimaging(CTorMRI)weretestedevery1—3monthslater.Follow—uptimewas4—50monthswiththemedianfollow—uptimeof12months.follow—upre—viewtotheendofJune2013.Results:Oversurvivalperiodwas4—50monthswithamediansurvivalof12months,1一yearsurvivalratewas58.1%,2
5、一yearsurvivalrate9.7%.Tumorthrombusresponserates(CR+PR)83.9%,CR15cases(48.4%),PR11cases(35.5%),SD4cases(12.9%),PD1case(3.2%).Kanplan—meierUnivariatea—nalysisshowedthatthedifferenceofsurvivalintumorthrombussite(P=0.039)andprescriptiondose(P=0.009)weresignificative(groupofIVCwasbetterthangroupofP
6、V_rr,groupof>44Gywasbetterthangroupof≤44Gy).COXmultivariateanalysisshowedthatprescriptiondosewassignificativeprognosticfactor(P=0.015).Conclusion:Gamma—knifetreatmentonprimarylivercancerwithportaland/orinferiorvenacavatumorthrombusissafeandef-fectivewithmildtoxicityandfewercomplications,anditca
7、nprolongsurvival,Gamma—knifeisoneoftheoptionalwaysofprimarylivercancerwithportaL/inferiorvenacavatumorthrombustreatment.Prescriptiondoseissignificativeprognosticfactor.【Keywords】primarylivercancer;portalvein/inferiorvenacavatumort
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