介入化疗及栓塞术联合放射治疗中晚期原发性肝癌

Combined therapy of interventional chemotherapy,embolism and radiotherapy in the treatment or advanced primary carcinoma or liver

为观察介人化疗及栓塞术联合放射治疗中晚期肝癌的近期疗效及副作用方法本文采用６４例确诊的无手术指征的中晚期肝癌，随机分为介人加放疗组与单纯放疗组各３２例，介入法采用动脉插管至肝固有动脉，灌注５－ＦＵ１０００ｍｇ＋卡铂３００ｍｇ＋表阿霉素３０ｍｇ，栓塞剂为４０％碘化油或明胶海绵。放疗采用高能Ｘ线（１８ｍｖ），肿块１０ｃｍ以下采用局野外照射，１０ｃｍ以上采用全肝移动条照射。结果介人加放疗组总有效率（ＣＲ＋ＰＲ）为５９．３％（１９／３２），单纯放疗组总有效率（ＣＲ＋ＰＲ）为３１．３％（１０／３２），两组比较有显著差异（Ｐ＜０．０５）。介人加放疗组平均生存期为１４７个月，单纯放疗组平均生存期为１１．８个月。互年生存率介人加放疗组为６０．８％，单纯放疗组为４４．１％，前者明显高于后者结论采用介人加放射综合治疗原发性肝癌较单纯放射治疗可明显地提高治疗的有效率，生存期及生存率。是中晚期肝癌理想的有效治疗手段之一。

Aim To observe short term therapeutic effect and side reaction in the combined therapy of interventionalchemotherapy, effelism and ndiotherapy. Methods 64 Patients with advanced carcinoma of liver without operation indication were randomly allocated into combined interventional therapy and radiotherapy group, and simple radiotherapy group (32cases in each group). In the interventional therapy group, catheters were catheterized into proper hepatic alters. Then we perfused 5- FU 1000mg, carboplatin 300mg, Mitomycin 30mg and suppository (40% iodized oil or gelfoam). In the radiotherapy, we used high - energy radiation. If the tumor was smaller than 10 cm, we gave local external irradiation. Othendse, wegaVe mobile initiation of the whole liver. Results In the combined therapy coup, the effective rate (CR + PR) was 59. 3%(19/32). And it was 31. 3% (10/32) in the control group. There was a significent difference between the two groups (P <0. 05). The avers survival was 14. 7 months in cocained interventional therapy and radiotherapy group, and 11. 8 months insimple radiotherapy group. The survival rate of a year was 60. 8% in the combined therapy, 44. 1 % in the controlled group.The former is distinctly hinger than the latter. Conclusion Combined treatment of interventional therapy and radiotherapy,can significantly raised the effective rate, vital stage and survival rate, compared with simple radiolherapy group. So it is anideal and effective treatment in the medium and late stage carcinoma of liver.