CAJ | 학술논문

目的：探讨γ-体部立体定向放疗（stereotactic body radiation therapy withγ-knife，γ-SBRT）联合热疗及靶向药物索拉非尼（sorafenib）治疗复发及转移性肝癌的效果。方法：自2007年8月至2009年12月，收治71例肝癌治疗后复发及转移患者。39例行γ-SBRT联合热疗，32例γ-SBRT联合热疗及索拉非尼治疗。结果：治疗后3个月总有效率为83.1%（59/71）。γ-SBRT+热疗组的1、3年局部控制率分别为41.0%（16/39）、18.0%（7/39））；γ-SBRT+热疗+索拉非尼组的1、3年局部控制率分别为56.3%（18/32）、28.1%（9/32）。γ-SBRT+热疗组的1、3年OS分别为41.2%（16/39）、17.9%（7/39），1、3年PFS分别为38.5%（15/39）、15.4%（6/39）；γ-SBRT+热疗+索拉非尼组的1、3年OS分别为62.5%（20/32）、28.1%（9/32），1、3年PFS分别为59.4%（19/32）、25.0%（9/32），经Log-rank检验两组的OS、PFS差异无显著性。结论：采用γ-SBRT联合热疗及索拉非尼对转移及复发性肝癌进行治疗是较有效的治疗方法。治疗过程安全，多数患者能耐受治疗。
목적：탐토γ-체부입체정향방료（stereotactic body radiation therapy withγ-knife，γ-SBRT）연합열료급파향약물색랍비니（sorafenib）치료복발급전이성간암적효과。방법：자2007년8월지2009년12월，수치71례간암치료후복발급전이환자。39례행γ-SBRT연합열료，32례γ-SBRT연합열료급색랍비니치료。결과：치료후3개월총유효솔위83.1%（59/71）。γ-SBRT+열료조적1、3년국부공제솔분별위41.0%（16/39）、18.0%（7/39））；γ-SBRT+열료+색랍비니조적1、3년국부공제솔분별위56.3%（18/32）、28.1%（9/32）。γ-SBRT+열료조적1、3년OS분별위41.2%（16/39）、17.9%（7/39），1、3년PFS분별위38.5%（15/39）、15.4%（6/39）；γ-SBRT+열료+색랍비니조적1、3년OS분별위62.5%（20/32）、28.1%（9/32），1、3년PFS분별위59.4%（19/32）、25.0%（9/32），경Log-rank검험량조적OS、PFS차이무현저성。결론：채용γ-SBRT연합열료급색랍비니대전이급복발성간암진행치료시교유효적치료방법。치료과정안전，다수환자능내수치료。
Objective:To investigate the efficacy of stereotactic body radiation therapy with gamma-knife (γ-SBRT) combined with targeted drug sorafenib and hyperthermia for the treatment of recurrent and metastatic hepatocellular carcinoma. Methods:A total of 71 patients with recurrent and metastatic hepatocellular carcinoma were admitted from August 2007 to December 2009. Among these patients, 39 were treated with γ-SBRT and hyperthermia (group 1); 19 were treated with γ-SBRT combined with sorafenib and hyperthermia (group 2). Results: The total efficacy rate after a three-month treatment was 83.1% (59/71). In group 1, the following results were obtained:one-and three-year local control rates of 41.0%(16/39) and 18%(7/39), respectively;one-and three-year overall survival (OS) rates of 41.2% and 17.9%, respectively; and one- and three-year progression-free survival (PFS) rates of 38.4% and 15.4%, respectively. In group 2, the following results were obtained:one-and three-year local rates of 56.3%(18/32) and 28.1%(9/32), respectively;one-and three-year OS rates of 62.5%and 28.1%, respectively;and one-and three-year PFS rates of 59.4%and 25.0%, respectively. Significant differences in OS and PFS were observed between the two groups. Conclusion:The combination ofγ-SBRT with targeted drug sorafenib and hyperthermia can be used effectively to treat recurrent and metastatic hepatocellular carcinoma. Adverse reactions are mild, and patients can tolerate this treatment.