介入治疗加三维适形放射治疗原发性肝癌的探讨

Combined therapy of transcatheter arterial chemoembolization and 3-dimensional conformal radiotherapy for unresectable primary hepatic carcinoma

目的探讨介入治疗加三维适形放射治疗对原发性肝癌的疗效和副作用.方法对51例不能手术切除的原发性肝癌患者,先肝动脉栓塞化疗(TACE),后三维适形放射治疗(3DCRT).肝动脉化疗用40%碘化油5～20 mL+顺铂60～100mg,阿霉素40～100mg,丝裂霉素10～20 mg;栓塞用1、2 mm的明胶海绵.适形放射治疗每次4.0、5.0 Gy,每周5次,8～14次,总剂量52.0～60.0 Gy.结果1、2和3 a生存率分别为86.3%、58.8%和35.3%.结论介入治疗加三维适形放射治疗原发性肝癌是一种较好的综合治疗方法.

[Objective] To study the therapeutic effect and side reaction of trans-hepatic arterial chemoembolization (TACE) combined with 3-dimensional conformal radiotherapy (3DCRT) for unresectable primary hepatic carcinoma (PHC). [Methods] Fifty-one patients with unresectable PHC were intialy treated with TACE and then sequentially with 3DCRT. All patients received heqatic arterial infusion chemotherapy including 40% lipiodol 5~20 mL, PDD 60~100 mg, adriamycin 40~100 mg mitomyin 10~20 mg, embolization with gelatin sponge. The 3DCRT with 4.0, 5.0 Gy per fraction, 5 times a weak to total dose of 52.0~60.0 Gy was given to all patients as well. [Results] The 1-,2-and 3-year survial rats were 86.3%, 58.8% and 35.3%. [Conclusion] The TACE combined with 3DCRT is an ideal and effectine treatment in unresectable primary hepatic carcinoma.