目的：观察射波刀（ cyberknife）治疗肝脏恶性肿瘤的疗效和安全性。方法：回顾性分析35例经射波刀治疗的肝脏恶性肿瘤患者，其中原发性肝癌12例，消化系统肿瘤肝转移16例，其他肿瘤肝转移7例。共57个病灶。所有患者行金标植入术，1周后行射波刀照射。平均肿瘤体积98.64ml，处方剂量18-51Gy，分割3-7次，等剂量线56%-85%。治疗后1-6个月复查，观察近期疗效，之后每3个月随访1次。结果：7例患者达到完全缓解，20例部分缓解，6例稳定，2例进展，有效率（ CR+PR）77.1%，局部控制率94.29%，中位TTP为12个月，中位生存期为23个月。所有患者耐受性良好，主要的不良反应为白细胞降低、食欲减退和疲劳。无Ⅳ级和Ⅳ级以上不良反应发生。结论：射波刀治疗肝脏恶性肿瘤有较高的有效率，安全性好，不良反应轻，患者易耐受。%Objective:To observe the efficacy and safety of cyberknife radiosurgery in patients with both primary or metastasis liver tumor. Methods:All 35 patients with liver tumor treated by cyberknife radiosurgery were included in this retrospective analysis,of which 12 were primary hepatic carcinoma,16 were hepatic metastases from gastrointesti-nal tract cancer and 7 from other sites,in totle 57 lesions. Fidicals were accurately placed to lable the lesions 7 days before radiotherapy with cyberknife. The mean gross tumor volume was 98. 64ml. A total dose of 18-51Gy with 2-7 fractions was prescribed to the 56% -85% isodose line of each patient. CT scans were performed 1-6 months after treatment to evaluate therapetic efficacy. The surveillance interval was every 3 months for 2 years. Results:Of 35 pa-tients,complete response( CR)were achived in 7 patients,partial response( PR)in 20 patients,stable disease( SD) in 6 patients,and progressed disease(PD)in 2 patients. The response rate was 77. 1% and disease control rate was 94. 29%. The medial time to progress(TTS)was 12 months,and the medial overall survival(OS)was 23 months. All patients completed radiotherapy and no severe side effects( gradeⅣ)were observed during treatment. Digestive disor-der and fatigue were most common side effects. Conclusion:Cyberknife is a safe and effective therapeutic method for liver tumor patients.
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