摘要目的 观察立体定向放疗大肝癌的生存及不良反应.方法 对2011-2014年在三0二医院收治的28例单发大肝癌行立体定向放疗患者进行观察.PTV处方剂量39～61Gy分3～9次,其中20例同步介入治疗.Kaplan-Meier法计算总生存、无进展生存、局控率,Cox模型对总生存率影响因素进行分析,Logistic回归分析对放射性肝损伤的影响因素.结果 1、2、3、5年总生存率分别为75％、57％、54％、22％,无进展生存率分别为59％、47％、36％、18％,局控率分别为92％、86％、86％、86％.4例患者出现放射性肝损伤,无因放射性肝损伤死亡病例.Child-Pugh分级是总生存率和放射性肝损伤的影响因素.结论 初步认为立体定向放疗是大肝癌患者的可替代的安全的治疗手段.

abstractsObjective To observe the survival and side effects of stereotactic body radiotherapy (SBRT) in large hepatocellular carcinoma (HCC) patients.Methods Twenty-eight large HCC patients undergoing SBRT in 302 Military Hospital from November 1,2011 to January 31,2014 were observed.The prescribed dose was 39-61 Gy/3-9f.Among them,20 patients simultaneously received transcatheter arterial embolization.The overall survival (OS),progression-free survival (PFS) and local control (LC) rates were calculated by using Kaplan-Meier method.The influencing factors of OS were analyzed by Cox regression model The influencing factors of radiation-induced liver disease (RILD) were identified by using Logistic regression analysis.Results The 1-,2-,3-and 5-year OS rates were 75％,57％,54％ and 22％,respectively.The 1-,2-,3-and 5-year PFS rates were 59％,47％,36％ and 18％,respectively.The 1-,2-,3-and 5-year LC rates were 92％,86％,86％ and 86％,respectively.Four patients suffered from RILD and none died from RILD.Child-Pugh classification was the influencing factor of OS and RILD.Conclusion It is preliminarily believed that SBRT is an alternative and safe treatment for patients with large HCC.