立体定向放疗联合瘤内无水酒精注射治疗小肝癌

Effect of Stereotactic Radiotherapy (SRT) Combined with Percutaneous Ethanol Injection Therapy (PEIT) for Small Hepatocarcinoma

目的:观察立体定向放疗—体部伽玛刀联合瘤内无水酒精注射治疗小肝癌的临床疗效。方法:将53例不能手术切除的小肝癌按患者意愿分成A组19例、B组14例、C组20例,各组肿瘤大小、肿瘤数目、AFP水平、肝功能情况无显著性差异。A组给予伽玛刀治疗后再行瘤内无水酒精注射治疗,B组单纯行伽玛刀治疗,C组单纯行瘤内无水酒精注射治疗。观察3组治疗后的近期疗效、局部控制率、生存期及治疗并发症。结果:治疗后3个月复查CT:A组完全缓解(CR)11例、部分缓解(PR)7例、稳定(SD)1例,总有效率(CR+PR)94.7%(18/19例),高于B组的85.7%(12/14例)、C组的75.0%(15/20例)。A组CR率为57.9%(11/19例),高于B组的42.9%(6/14例)和C组的30.0%(6/20例)。A组2年和3年生存率为73.7%(14/19例)和57.9%(11/19例),分别高于B组、C组的50.0%(7/14例)和35.7%(5/14例)、55.0%(11/20例)和35.0%(7/20例)。结论:伽玛刀与瘤内无水酒精注射联合治疗小肝癌比单纯的伽玛刀治疗或单纯的瘤内无水酒精注射治疗更有效。

Objective： To discuss the effect of stereotactic radiotherapy （SRT） combined with percutaneous ethanol injection therapy （PELT） for small hepatocarcinoma. Methods： Fifty-three cases of small hepatocarcinoma patients were divided into 3 groups. Group A included 19 patients who underwent PElT after fractional stereotactic radiotherapy （FSRT）. Group B included 14 patients who received FSRT alone. Group C included 20 pa- tients who underwent PElT alone. Results： All patients took CT examination at 3 months after treatment. The complete remission rates in group A, B and C were 57.9%, 42.9% and 30.0%, respectively. The 2- and 3-year survival rates were 73.7% and 57.9% in group A, 50.0% and 35.7% in group B, and 73.7% and 57.9% in group C. Group A had higher complete remission rate, 2- and 3-year survival rates （P〈0.05）. Conclusion： FSRT combined with PElT is an effective treatment for small hepatocarcinoma.