三维适形放射治疗原发性肝癌的近期临床观察

Clinical observation on three dimensional conformal radiation therapy for hepatocellular carcinoma

目的观察三维适形放射治疗原发性肝癌的近期治疗效果及毒副反应。方法对22例不适合手术治疗、不同临床分期的原发性肝癌患者行三维适形放射治疗。根据患者肿瘤大小及肝功能状况,每次分割剂量1.8～2Gy,每日一次,每周五次,照射次数为22～30次(中位27次),总剂量44～60Gy,平均(54±6.1)Gy。观察近期疗效及放疗毒副反应。结果 22例患者临床分期Ⅰ期1例,Ⅱ期10例,Ⅲ期4例,Ⅳa期6例,Ⅳb期1例。根据CT检查、AFP水平及临床症状,治疗的近期有效率分别为68.2%(15/22)、76.5%(13/17)、85%(17/20)。毒副反应包括低热(18/22)、乏力(18/22)、恶心(16/22)、右上腹隐痛(6/22)、呕吐(5/22)及轻微肝功能改变,毒副反应均能耐受。结论三维适形放射治疗不能手术的原发性肝癌安全、有效。

Objective To observe the therapeutic effect and adverse events of 3-dimensional conformal radiation therapy (3D-CRT) for hepatocellular carcinoma exculsive of resection possibility.Methods Twenty-two patients with hepatocellular carcinoma exculsive of resection possibility due to any reasons received 3D-CRT.A fractionated dosage from 1.8Gy to 2Gy according to the tumor size and patients liver function was prescribed once daily and five times weekly,with a total radiation dosage of 44-60Gy and mean dosage of (54±6.1)Gy.Results According to CT scan results,AFP levels and clinical symptoms,the response rates were 68.2%(15/22),76.5%(13/17) and 85%(17/20).The adverse events were acceptable,including low-grade fever(18/22),malaise(18/22),nausea(16/22) and vomiting(5/22),insidious pain on right-upper quadrant(6/22),and slight damage on liver function respectively.Conclusion 3D-CRT is an effective and safe treatment method for hepatocellular carcinoma unsuitable for resection.