2009年 第11卷 第10期
原发性肝癌三维适形和调强放疗的基础和临床研究
复旦大学附属肿瘤医院放射治疗科，上海 200032
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摘要
报告三维适形（3-dimensional conformal radiation therapy, 3DCRT）和调强放疗（intensity-modulated radiation therapy, IMRT）治疗原发性肝癌（HCC）的基础和临床研究,建立了3DCRT和IMRT放疗HCC的技术，进行3个临床试验，获得了令人鼓舞的3年总生存率：28 ％～33 ％。治疗并发症主要是放射性肝病（RILD），此并发症的死亡率为76 ％，预防RILD最有效的方法是把对正常肝脏的放射剂量限制在安全的范围内。我国的HCC病人大都伴有肝硬化，伴发的肝硬化损害了肝脏对放射损伤的修复和肝脏再生的能力，他们的放射耐受剂量是（全肝平均剂量）：Child-Pugh A病人23 Gy，Child-Pugh B病人6 Gy，这个耐受量显著低于目前国际上通用的30 Gy。研究建立了用于预测我国HCC病人放疗中发生RILD发生概率的Lyman数学模式，其参数明显不同于国外的模式，并将一整套适合我国国情的HCC放疗技术成功地进行了临床实践，证实了放疗可以作为不能手术肝癌的一种治疗选择。
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参考文献
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