原发性肝癌介入治疗加三维适形放射治疗的疗效

Clinical study of unresectable primary hepatic carcinoma treated by transarterial chemoembolization and three-dimensional conformal radiotherapy.

目的探讨肝动脉化疗栓塞(TACE)后采用三维适形放射治疗(3-DCRT)原发性肝癌的疗效.方法 50例肝癌中25例TACE+3DCRT(综合组),25例单纯TACE(对照组).2个组均行TACE 1～3次,3-DCRT 采用6/15MVX线,3Gy/次 ,1次/天,总剂量45～54Gy.结果综合组近期有效率(CR+PR)为84.0%,对照组为56.0%(χ2=4.67,P<0.05).其中1、2年生存率综合组和对照组分别为76.0%、56.0%和48.0%、24.0%(χ2=4.16、5.33,P<0.05).结论 TACE+3DCRT是治疗不宜手术的原发性肝癌的较好方法.

Objective To evaluate the therapeutic efficacy of three dimensional conformal radiotherapy（3-DCRT） plus transarterial chemoembolization （TACE） for unresectable primary hepatic carcinoma （PHC）. Methods Fifty patients with unresectable PHC were divided into two groups：25 were treated with TACE plus 3 - DCRT （combined group） and others were treated with TACE alone（ control group）. TACE were treated with 1 - 3 sessions in both group,3Gy per fraction,once daily,the total tumor dose was 45 -54Gy. Results The response rate （ CR ＋ PR ） of combined group and control group were 84.0% and 56.0% （ χ^2 = 4.67, P 〈 0.05 ） . The 1 - year,2 - year survival rates of combined group and control group were 76.0% ,56.0% and 48.0% ,24.0% （ χ^2 =4.16,5.33 ,P 〈 0.05 ）. Conclusion Combined 3DCRT and TACE is more effective than TACE alone. It can effect a longer interval of control and survival in patients with unresectable PHC.