肝动脉栓塞化疗联合三维适形放疗治疗Ⅱ期原发性肝癌疗效分析

The therapeutic effects of three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization for stage Ⅱ primary liver cancer

目的探讨肝动脉插管栓塞化疗（TACE）联合三维适形放疗（3DCRT）治疗Ⅱ期原发性肝癌的疗效。方法81例患者分为两组，A组36例采用TACE联合3DCRT，B组45例采用单纯TA—CE。比较两组近期疗效，1、2、3年生存率及死亡患者的平均生存时间及毒副作用。结果随访率为100％，随访时间满1、2、3年者分别为55、19、6例。A组有效率为72％，B组为60％（χ^2=1．32，P〉0．05）。A和B两组1、2、3年生存率、死亡患者平均生存时间分别为83％、63％、25％、21个月和75％、37％、8％、16个月，两组差异有统计学意义（χ^2=4．87，P〈0．05）。两组毒副作用相似。结论TACE联合3DCRT治疗Ⅱ期原发性肝癌对远期生存有益且毒副作用元明显增加，是一种较单纯TACE更有效的手段。

Objective -To evaluate the therapeutic effects of three-dimensional conformal radiation therapy （3DCRT） in combination with transcatheter arterial chemoembolization （TACE） for stage 11 primary liver cancer. Methods Eighty-one patients were retrospectively analyzed, including 36 received 3DCRT combined with TACE （Group A） and 45 received TACE alone （Group B ）. The short-term therapeutic effects and 1-, 2-, 3-year survival rates, average survival time of the dead patients, and side effects were compared between the two groups. Results The follow-up rate was 100%. The numbers of patients finished 1-, 2-and 3-year follow-up were 55,19 and 6, respectively. The reponse rates were 72% in group A, and 60% in group B, which were not significant different （ χ^2 = 1.32,P 〉 0.05 ）. The 1 -, 2- and 3-year survival rates of the dead patients were 83% , 63% and 25% in group A and 75% , 37% and 8% in group B. The corresponding average survival time was 21 nlonths and 16 months, respectively. The differences of 2- and 3- year survival rates were significant between group A and B. （ χ^2= 4.87, P 〈 0.05 ）. The incidence and severity of side effects did not differ significantly between the two groups. Conclusions In patients with stage Ⅱ primary liver cancer, 3DCRT combined with TACE, being more effective than TACE alone, can prolong the long-term survival without increasing the toxicities.