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目的回顾性分析全身伽玛刀治疗膀胱癌的近期疗效和放射治疗反应。方法对采用全身伽玛刀治疗的21例膀胱癌的患者进行回顾性分析,其中男19例,女2例;年龄39～94岁;病理证实12例,临床病史结合影像(CT、彩超、MRI等)检查等诊断9例;病例中不能手术者(高龄、不能耐受手术等)9例,手术后复发者8例,拒绝手术者4例。用体位固定床和真空负压袋固定体位,在螺旋CT下行薄层定位扫描,应用TPS治疗规划系统制定治疗计划,单次周边剂量为4～6Gy,用50%～70%的等剂量曲线,分7～10次,隔日治疗,总剂量在35～45Gy。结果治疗过程中,血尿消失者10例(47.6%),明显减轻者8例(38.1%),其余3例无改善(14.3%);治疗后3～6个月影像复查,病灶完全消失者5例(CR23.8%),部分缓解者12例(PR57.1%),无变化者4例(NC19.1%,其中失访1例)。临床总有效率为85.7%,影像有效率(CR+PR)为80.9%。结论体部伽玛刀治疗膀胱癌近期可获得较高的局部控制率及症状缓解率,尤其对不能手术的膀胱癌患者提供了有效、安全、可靠的治疗手段。
Objective To retrospectively analyze the short-term effect and radiotherapy response of the whole body gamma knife in the treatment of bladder cancer. Methods A retrospective analysis was performed on 21 cases of bladder cancer treated with whole-body gamma knife radiography, including 19 males and 2 females, aged from 39 to 94 years old. Twelve cases were confirmed by pathology. CT and color Doppler ultrasound combined with MRI Etc.) were diagnosed in 9 cases; cases can not surgery (old age, can not tolerate surgery, etc.) in 9 cases, 8 cases of recurrence after surgery, refused to surgery in 4 cases. Fixed body position with a fixed bed and vacuum bag vacuum position in the spiral CT down thin layer positioning scan, the application of TPS treatment planning system to develop treatment plans, a single peripheral dose of 4 ~ 6Gy, with 50% to 70% of the isodose curve, Points 7 to 10 times, every other day treatment, the total dose of 35 ~ 45Gy. Results During treatment, hematuria disappeared in 10 cases (47.6%), significantly reduced in 8 cases (38.1%), the remaining 3 cases without improvement (14.3%); 3 to 6 months after treatment, the image review, the complete disappearance of the 5 Cases (CR23.8%), partial remission in 12 cases (PR57.1%), no change in 4 cases (NC19.1%, of which 1 case lost). The total clinical effective rate was 85.7% and the imaging effective rate (CR + PR) was 80.9%. Conclusion Gamma knife treatment of bladder cancer in recent years to obtain a higher local control and symptom response rate, especially for inoperable bladder cancer patients with an effective, safe and reliable treatment.