中晚期肝癌介入治疗结合三维适形放疗53例临床观察

CLINICAL OBSERVATION ON INTERVENTIONAL TREATMENT OF ADVANCED LIVER CANCER COMBINED THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY

目的观察介入治疗结合三维适形放疗治疗中晚期肝癌疗效。方法2003年1月—2006年6月采用3DCRT结合TACE治疗中晚期原发性肝癌53例。KPS评分≥60;肝功能Child-pugh A级或B级;门静脉主干无癌栓;白细胞和血小板均在正常范围;患者不愿手术或外科医生会诊无手术指征者。按全国肝癌诊疗规范临床诊断原发性肝癌53例,其中12例有肝穿刺病理或细胞学结果,肿瘤<3cm5例,3～5cm23例,>5cm25例。结果CR9例(17%),PR28例(54%),NC9例(17%),PD5例(11%),总有效率(CR+PR)为71%。结论三维适形放疗结合TACE为中晚期肝癌提供了一条有效的治疗方法。可有效控制肿瘤,解除患者痛苦,提高患者的生存质量和生存期。

Objective To investigate the involvement of interventional treatment combined threedimensional conformal radiotherapy （3DCRT） in advanced liver cancer. Methods From January 2003 to June 2006 during the TACE combined with the use of 3DCRT in the treatment of 53 cases with advanced primary liver cancer. KPS score≥60; liver function ChildpughA or B grade; without portal vein tumor thrombus; leukocytes and platelets were within the normal ranger patients surgeons do not want surgery or no surgery indications consultation. According to the national norms for clinical diagnosis of liver cancer treatment in 53 cases with primary liver cancer, of which 12 cases of liver punctured the results of pathology or cytology, tumor less than 3cm 5 cases, 3-5cm 23 cases, 25 cases were more than 5cm. Results There were CR 9 cases in the results （17%）, PR 28 cases （54%）, NC 9cases （17%） and PD 5 cases（11%）, the total effective rate （CR ＋ PR） was 71%. Conclusion Threedimensional conformal radiotherapy combined TACE for advanced HCC has provided an effective treatment. It can effectively control tumors, lift pain of patients, improve life quality and survival period of patients.