肝动脉化疗栓塞联合三维适形放射治疗原发性肝癌的临床疗效

Clinical efficacy of transcatheter arterial chemembolization combined with three-dimensional conformal radiotherapy for primary hepatocellular carcinoma

目的观察肝动脉插管化疗栓塞（TACE）联合三维适形放疗（3D—CRT）治疗原发性肝癌的疗效。方法对采用影像学联合甲胎蛋白标准确诊的原发性肝癌患者，选择其中不能手术切除的54例患者，先行TACE治疗1～3次，2～3周后行3D—CRT治疗，依据WHO肿瘤近期疗效报告标准判定近期疗效；根据3年内生存率评价远期疗效。观察联合治疗近期和远期疗效。结果54例患者均完成治疗，9例病情完全缓解（16．67％）；26例部分缓解（48．15％）；稳定7例（12．96％）；进展4例（7．41％）；死亡8例（14．81％）。患者治疗后均随访，最长者随访3年，1、2、3年生存率分别是85．19％（46／54）、62．96％（34／54）及35．19％（19／54）。结论对不能手术的原发性肝癌患者行TACE联合3D—CRT治疗，不但能够有效控制病情，而且副作用小，患者耐受性好。

Objective To evaluate the clinical efficacy of transcatheter arterial chemembolization （TACE） and three-dimensional conformal radiotherapy （3D-CRT） for primary hepatocellular carcinoma （PHC）. Methods 54 patients with inoperable PHC confirmed by imaging and AFP were given sequence of treatment, namely, TACE was performed first, 1 -3 times, followed by 3D-CRT with an interval of about 2 3 weeks. Short-term efficacy （ according to WHO report） and long-term efficacy （ according to three-year survival rate） were observed after combined treatment. Results Of all 54 patients, 9 patients （ 16.67% ） achieved complete response （ CR）, 26 had partial response （ PR）, 7 （ 12.96% ） achieved stable disease （ SD）, 4 （7.41%） were progressional disease （PD） , 8 （ 14.81% ） were dead. All patients were followed up and the longest follow-up period was 3 years. One, two, three-year survival rates were 85. 19% （46/ 54） ,62.96% （34/54） and 35.19% （19/54） respectively. Conclusions The newly combined modality of TACE and 3D-CRT resuhs in a good outcome, which increases the survival period of inoperable PHC patients as well as improves their quality of life, with little tolerable side-effects.