CAJ | 학술논문

目的：观察体部伽玛刀（SBRT）联合高强度聚焦超声（HIFU）治疗中晚期原发性肝癌（PHC）的疗效及毒性反应。方法选择2012年10月至2013年7月武警山东省总队医院肿瘤科放疗中心收治的中晚期PHC 20例，均给予SBRT联合HIFU治疗，SBRT取等剂量线为50％～60％，单次周边剂量每次3～6 Gy，共8～15次，每日1次，每周5次，总剂量为30～60 Gy；同时每周进行1次HIFU 治疗，在SBRT后2～4 h实施，靶区温度控制在42℃以上，共3～5次。治疗期间给予常规保肝治疗，同时避免使用任何化疗药物，每周复查血常规和肝功能。结果治疗结束后2～3个月复查，完全缓解2例（10．0％），部分缓解15例（75．0％），无变化2例（10．0％），恶化1例（5．0％），近期总有效率85．0％。上腹不适、腹痛等临床症状改善有效率为75％，腹水患者治疗后缓解有效率为72．7％。结论 SBRT联合HIFU治疗中晚期PHC近期疗效肯定，可明显改善患者生存质量，且毒性反应可耐受，是一种安全可靠的治疗方法。
목적：관찰체부가마도（SBRT）연합고강도취초초성（HIFU）치료중만기원발성간암（PHC）적료효급독성반응。방법선택2012년10월지2013년7월무경산동성총대의원종류과방료중심수치적중만기PHC 20례，균급여SBRT연합HIFU치료，SBRT취등제량선위50％～60％，단차주변제량매차3～6 Gy，공8～15차，매일1차，매주5차，총제량위30～60 Gy；동시매주진행1차HIFU 치료，재SBRT후2～4 h실시，파구온도공제재42℃이상，공3～5차。치료기간급여상규보간치료，동시피면사용임하화료약물，매주복사혈상규화간공능。결과치료결속후2～3개월복사，완전완해2례（10．0％），부분완해15례（75．0％），무변화2례（10．0％），악화1례（5．0％），근기총유효솔85．0％。상복불괄、복통등림상증상개선유효솔위75％，복수환자치료후완해유효솔위72．7％。결론 SBRT연합HIFU치료중만기PHC근기료효긍정，가명현개선환자생존질량，차독성반응가내수，시일충안전가고적치료방법。
Objective Observation of body gamma knife radiotherapy ( SBRT ) in the treatment of ad-vanced primary hepatic carcinoma(PHC) the efficacy and side effects.Methods In 20 cases of advanced PHC select the Armed Police Corps in Shandong province hospital oncology radiotherapy center in 2012 October to 2013 July were,were treated with SBRT combined with HIFU treatment ,SBRT isodose line is 50%-60%, single peripheral dose every 3-6 Gy,a total of 8-15 times, 1 times a day,5 times a week,a total dose of 30-60 Gy;at the same time,1 times a week after SBRT HIFU treatment,2-4 h implementation,target zone tempera-ture control in 42℃above,a total of 3-5 times.During treatment,treated with routine treatment, while avoiding the use of any drug, blood and liver function examination weekly.Results After the treatment in 2-3 months, 2 cases of CR(10%),PR 15 cases(75%),NC 2 cases(10%),PD 1 cases(5%),the total efficiency of 85%. Epigastric discomfort,abdominal pain and other clinical symptoms and improve efficiency of 75%,treatment of patients with ascites after remission rate was 72.7%.Conclusion SBRT combined HIFU in the treatment of advanced PHC short-term efficacy,can significantly improve the quality of life of patients ,and the toxicity can be tolerated,is a safe and reliable treatment.