三维适形放疗联合奥沙利铂化疗治疗肝转移癌的临床观察

Effects of three-dimensional conformal radiotherapy combined with oxaliplatin on patients with liver metastases cancer

目的分析三维适形放疗(three-dimensional conformal radiotherapy 3-DCRT)联合奥沙利铂化疗治疗肝转移癌的临床疗效。方法 30例肝转移癌静脉滴入奥沙利铂130 mg/m2,第1天静脉滴入;5-氟尿嘧啶300 mg/m2和亚叶酸钙200 mg/m2第1～5天静脉滴入,间隔3周重复,共2个疗程。同步进行三维适形放疗,设4～6个弧形或非共面适形固定野照射,参考剂量曲线选定为80%。放疗处方剂量45～55 Gy,中位剂量50 Gy3,～4 Gy/次,3次/周。结果治疗后3～6个月内复查增强CT或MRI,30例中,3例完全缓解(CR),16例部分缓解(PR),7例无变化(NC)4,例恶化(PD),总有效率(CR+PR)为63.3%,肿瘤局部控制率为78.5%,中位生存期15个月,1、2、3年生存率分别为65.3%、31.1%和10.6%,全组无严重并发症发生。结论三维适形放疗联合奥沙利铂治疗肝转移癌能提高肿瘤局部照射剂量和增加肿瘤局部控制率,是一种安全、有效的治疗手段。

Objective To observe the clinical efficacy of three-dimensional conformal radiotherapy（3-DCRT） combined with oxaliplatin（L-OHP） on patients with liver metastases cancer.Methods 30 patients with liver metastases cancer received L-OHP 130 mg/m2,D1 iv drip.5-FU 300 mg/m2 and CF 200 mg/m2 with iv drip on D1-5 was given in two cycles（Twenty-one days as one cycle）.30 patients received 3-DCRT（45-55 Gy/8-12f,3-4 Gy/f,3f/w,prescribed at the 80% isodose）.Results CT or MRI were performed 3-6 months after radiotherapy.3 patients were CR,16 were PR,7 were NC and 4 were PD.The overall response rate（CR＋PR） was 63.3%.The 1-,2-,and 3-year survival rates were 65%,31% and 10% respectively.The median survival duration was 15.0 months.No serious complication was observed in the course.Conclusion 3DCRT combined with oxaliplatinL-OHP,5-FU and CF is an effective and safe treatment modality for liver metastases cancer.It can improve life quality and prolonging survival time of patients as well.