介入治疗配合适形放疗应用于不适合手术原发性肝癌的临床观察

Clinical Observation of Interventional Therapy Combination with Conformal Radiotherapy Used for the Unsuitable Surgery of Primary Liver Cancer

目的:评价肝动脉化疗栓塞(TACE)联合三维适形放疗(3DCRT)治疗原发性肝癌(PHC)的疗效。方法:将45例原发性肝癌随机分为观察组22例和对照组23例。观察组行TACE联合3DCRT治疗,对照组单纯行TACE治疗。结果:对照组和观察组总有效率分别为43.5%和81.8%,有显著性差异(P<0.05)。对照组1年,2年,3年生存率分别为51%、24%、15%;观察组分别为78%、60%、41%。两组各年生存率比较均有显著性差异(P<0.05)。两组患者在TACE后出现不同程度的发热、白血胞降低、胃肠道反应和腹痛等,经对症治疗后缓解。放疗中出现Ⅰ级肝脏急性反应2例,经保肝治疗后在1个月内恢复。结论:3DCRT结合TACE治疗中晚期原发性肝癌优于单纯TACE治疗,近期疗效确切,提高了局部控制率和生存率,并发症少,是中晚期原发性肝癌行之有效的治疗方法。

Objective： To evaluate the hepatic arterial chemoembolization （TACE） combined with three-dimensional conformal radiotherapy （3DCRT） treatment of primary liver cancer （PHC） patients. Methods： 45 cases of primary liver cancer were randomly divided into two groups, the observation group 22 cases, the control group 23 cases. 3DCRT combination with TACE treatment of the Observation group, the control group simply did TACE treatment. Results： In control group and observation group, the total effective rates were 43.5 % and 81.8 %, there is significant difference （P 〈0.05）. 1 age,2 ages, 3 ages control group, survival rates were 51%, 24 %, 15 %; the observation group were 78 %, 60 %, 41%. Two groups＇ survival rate of the comparison group were significantly different （P 〈0.05）. Two groups＇ patients after TACE at varying degrees of fever, white blood cell reduction of gastrointestinal reactions and abdominal pain, etc. atter symptomatic remission after treatrnent. Radiotherapy appeared in I -level response to two cases of acute liver by the liver after treatment at one month to restore. Conclusion： 3DCRT combined with TACE treaanent of advanced primary liver cancer is better than TACE treatment, the precise short-term efficacy improve the local control rate and survival rate fewer complications of advanced primary liver cancer are effective treatment methods.