沙利度胺联合三维适形放射治疗中晚期肝癌

Effect of three dimensional conformal radiation therapy combined with thalidomide on advanced hepatic carcinoma

目的探讨沙利度胺(TLD)联合三维适形放射(3-DCRT)治疗中晚期原发性肝癌的临床疗效及安全性。方法将入组的中晚期原发性肝癌患者44例随机分为观察组24例和对照组20例。观察组在3-DCRT基础上加口服TLD,对照组不用TLD。结果近期疗效显示观察组总有效率为87.5%(21/24),明显高于对照组的65.0(13/20)(P<0.05)。两组未见严重不良反应发生。随访2年,观察组1、2年生存率分别为75.5%(18/24)、58.3%(14/24);对照组为50.0%(10/20),35.0%(7/20)(P<0.05)。结论应用沙利度胺与三维适形放疗联合治疗中晚期原发性肝癌疗效明显,不良反应轻,具有一定的临床应用价值。

Objective： To observe the efficacy and safety of three dimensional conformal radiation therapy（3-DCRT） combined with thalidomide（TLD） on advanced hepatic carcinoma.Methods： Forty-four patients with primary liver cancer were randomly divided into therapy group and control group.The TLD group were treated by 3-DCRT combined with TLD,and the control group were only treated by 3-DCRT.The main outcome measure was the response rate and toxin response and secondary outcome measure was the overall survival rate.Results： The overall response rate was 87.5% in the TLD group and 65.0% in the control group（P0.05）.There was no severely side-effect in both of the groups.The overall 1 year and 2-years survival rates were 75.5% and 58.3% respectively in the TLD group,and 50.0% and 35.0% respectively in the control group.There was significant difference in the 2-and 3-years survival rates between the two groups（P0.05）.Conclusion： Combined thalidomide with 3-DCRT is more effective than 3-DCRT alone for the advanced hepatocellular carcinoma.The adverse effects are tolerable,so the combined therapy has its value for clinical application.