| 王逸君,张立娜,常冬姝,李宏奇,王颖杰,夏廷毅.体部γ刀治疗异时性双肾癌疗效初探[J].中华放射医学与防护杂志,2014,34(2):125-128 |
| 体部γ刀治疗异时性双肾癌疗效初探 |
| The therapeutic effect of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma |
| 投稿时间：2013-07-09 |
| DOI：10.3760/cma.j.issn.0254-5098.2014.02.012 |
| 中文关键词: 肾癌 体部γ刀 双侧肿瘤 |
| 英文关键词:Renal cell carcinoma Stereotactic γ-ray body radiation therapy Asynchronous bilateral tumor |
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| 中文摘要: |
| 目的 探讨体部γ刀治疗异时性双肾癌的可行性、临床疗效和放射损伤情况。方法 回顾性分析2002年至2012年间9例一侧肾癌根治术后发生对侧肾癌，但无再次手术机会的异时性双肾癌患者接受体部γ刀治疗资料。治疗采用OUR-QGD型立体定向γ射线全身治疗计划系统。放疗计划要求50%剂量线覆盖计划靶体积（PTV），70%剂量线覆盖大体靶体积（GTV）。以50%剂量线为处方剂量线，单次照射量3~5 Gy，1次/d，5次/周。PTV边缘总剂量36~51 Gy，GTV边缘总剂量60~85 Gy。计算局部控制率和生存率。结果 随访截至2013年3月，随访率100%。9例患者中，完全缓解1例，部分缓解4例，稳定3例，进展1例，总有效率55.6%。1、3、5年局部控制率分别为64.8%、43.2%、43.2%。全组患者放疗后中位生存期24（3~122）个月， 1、3、5年总生存率分别为66.7%、53.3%及35.6%。急性放射反应4例，包括骨髓抑制1级2例、胃肠反应1级2例；晚期放射反应2例，均为胃肠反应2级。所有患者放疗后KPS评分较前提高，肾功能基本正常。结论 初步显示体部γ刀治疗异时性双侧肾癌安全有效，是一种可以选择的治疗方式。 |
| 英文摘要: |
| Objective To preliminarily evaluate the feasibility, therapeutic effect and normal tissue complications of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma. Methods Nine patients with inoperable asynchronous bilateral renal cell carcinoma with a median time from the resection of the primary focus and discovery of the contralateral focus underwent stereotactic γ-ray body radiotherapy with OUR-QGD stereotactic γ-ray whole body therapeutic planning system. 50% isodose line, as the prescription dose line, was to cover the planning target volume (PTV) and the 70% isodose line was to cover the gross target volume (GTV). Radiotherapy was delivered, with a single dose of 3-5 Gy per fraction, one fraction per day, 5 fractions per week, and totally 10-17 fractions. The PTV edge total dose was 36-51 Gy, and the GTV edge total dose was 60-85 Gy. The patients were followed up for a median time of 24 months to evaluate the local control rate and overall survival rate. Results Of the 9 patients, 1 presented complete remission (11.1%) and 4 partial remission (44.5%), with a total effective rate of 55.6%. The 1-, 3-, and 5-year local control rates were 64.8%, 43.2%, and 43.2% respectively. The 1-, 3-, and 5-year overall survival rates were 66.7%, 53.3%, and 35.6% respectively. Four patients (44.4%) had acute radiation reaction: 2 cases with grade 1 leukocytopenia and 2 cases with grade 1 gastrointestinal reactions. Two patients showed grade 2 late radiation-induced reaction in gastrointestinal system. The Karnofsky score was significantly increased and the renal function was normal after radiotherapy. Conclusions Stereotactic γ-ray body radiation therapy is safe and effective in the treatment of asynchronous bilateral renal cell carcinoma. |
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