283例原发性肝癌三维适形放疗的预后因素分析

Prognostic factors when using three-dimensional conformal radiotherapy to treat primary liver cancer:an analysis of 283 cases

目的评价三维适形放射治疗(3DCRT)对原发性肝癌的疗效,探讨其预后影响因素。方法对283例原发性肝癌患者进行3DCRT,肿瘤剂量(51.85±6.55)Gy,每次分割剂量(4.55±1.02)Gy,照射次数(10±4)次,每周3次,隔日1次。结果原发性肝癌3DCRT总有效率(CR+PR)为47.35%(134/283),1、3、5年总生存率分别为57.0%、29.0%和18.0%,性别、CLIP分期、GTV、PVTT和Child-Pugh分级对预后影响的差异有统计学意义(P均<0.01),性别、GTV、PVTT和Child-Pugh分级是独立的预后因素(P=0.008、0.007、0.006和0.003)。结论性别、GTV、PVTT和Child-Pugh分级是影响原发性肝癌3DCRT独立的预后因素。

Objective To evaluate the efficacy of three-dimensional conformal radiotherapy（3DCRT）to treat primary liver cancer （PLC）and investigate the prognostic factors associated with its use. Methods PLC patients（n = 283）were treated with 3DCRT using a total dose of 51.85±6.55 Gy（4.55±1.02 Gy/fraetion,3 fractions/week, 10±4 total fractions）. Results The response rate（CR＋PR）was 47.35%（ 134/283 ）.The 1-, 3-, and 5-year overall survival rates were 57.0%, 29.0% and 18.0%, respectively.Gender, CLIP stage, GTV, PVTT and Child-Pugh class were found to significantly affect overall survival（P〈0.01 ）.Independent prognostic factors were gender （P=0.008）, GTV （P=0.007）, PVTT （P=0.006）and Child-Pugh class （P=0.003）.Conclusion Gender, GTV, PVTT and Child-Pugh class may be independent prognostic factors when using 3DCRT to treat PLC.