三维适形放疗治疗原发性肝癌81例

Study on three-dimensional conformal radiotherapy for 81 patients with primary hepatic carcinomas

目的分析三维适形放疗（3D．CRT）治疗原发性肝癌的临床疗效。方法对中晚期原发性肝癌81例采用3D．CRT，每次200～400cGy，生物总剂量4800。5500cGy，中位剂量为4580cGv，随访时间2～25个月。按WHO肿瘤疗效标准评价近期疗效。结果81例均完成治疗，完全缓解21例，部分缓解46例，有效率82．7％（67／81）。1、2年总生存率分别为43％、26％。多因素分析结果显示近期疗效、总剂量、是否远处转移、临床分期、肿瘤大小、Child分级对患者生存率有影响（均P〈O．05）。结论3D—CRT对原发性肝癌有较好的治疗作用，能够延长原发性肝癌患者的生存期。

Objective To analyse the efficacy of three-dimensional conformal radiotherapy （3D-CRT） for hepatic carcinomas. Methods 81 patients with advanced hepatic carcinoma were treated at every turn of 200-400 cGy to a total dose of 4800-5500 eGy. Average-dose was 4580 cGy. Following up time was 2- 25 monthes. Recent effect was evaluated according to WHO tumor evaluation standard. Results 81 patients accomplished the treatment. The local response rate was 82.7 % （67/81） after treatment with 21 cases CR, 46 cases PR. The 1, 2 year overall survival rates were 43 %, 26 %. In the multivariate analysis, the recent effect, the total dose, metastasis, clinical staging, the diameter of the tumors and Child grade presages had statistical significance for overall survival （all P 〈 0.05）. Conclusion 3D-CRT is preferable therapeutic action for primary hepatic carcinomas and can prolong the survival term.