介入联合三维适形放疗治疗原发性肝癌疗效分析

TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION COMBINED WITH 3-DIMENSIONAL CONFORMAL RADIOTHERAPY FOR 70 ADVANCED PRIMARY HEPATIC CARCINOMA

目的探讨肝动脉化疗栓塞(TACE)结合三维适形放射治疗(3DCRT)对原发性肝癌(PHC)的疗效。方法对70例中晚期原发性肝癌患者,采用先TACE后3DCRT相结合,观察疗效及生存率,并以Cox回归模型分析预后因素。70例中单发病灶20例,多结节病灶50例。放射治疗总剂量48～62.5Gy。结果完全缓解(CR)7例,部分缓解(PR)41例,有效率68.6%。6个月生存率为62.9%(44/70),1、2年生存率分别为32.9%(23/70)、4.3%(3/70),中位生存期为7个月。多因素分析结果显示肿瘤最大直径对放射治疗后患者生存率的影响具有统计学意义(P<0.05)。结论TACE结合3DCRT是治疗PHC的有效,可行的治疗手段。

Objective To investigate the efficacy of transcatheter arterial chemoembolization （TACE） combined with 3-dimensional conformal radiation therapy（3DCRT） for advanced primary hepatic carcinoma （PHC）. Methods 70 patients with advanced PHC were initially treated with TACE and then sequentially with 3DCRT. The therapeutic effect and survival rate of the patients were assessed as endpoints with Cox proportional hazard model used to define prognostic factors. Of these 70 patients ,20 presented with a sol- itary lesion and 50 with multiple ones. The total radiation dose of 48 - 62. 5 Gy was delivered. Results The local response rates were 68. 6% after treatment with 7 CR,41 PR. The 1,2 year survival rates were 32. 9% （23/70） ,4. 3% （3/70）. respectively,with a median survival duration of 7 months. In the multivariate analysis,the Maximum Diameter presented prognostic significance for overall survival （ P 〈 0. 05 ）. Conclusion TACE combined with 3 DCRT is an effective,feasible approach in the treatment of advanced primary hepatic carcinoma.