TACE联合3-DCRT及热疗治疗中晚期原发性肝癌的疗效观察

The effect of TACE combined with 3-DCRT and hyperthermia on patients with advanced primary hepatic carcinoma

目的 探讨肝动脉灌注栓塞化疗（TACE）联合三维适形放疗（3-DCRT）及热疗治疗中晚期原发性肝癌的疗效及不良反应.方法 对54例肝癌患者先行TACE治疗1～2次,一次TACE后行4次热疗;4周后行3-DCRT治疗,同时行热疗.放疗分割剂量2.6～3.0Gy/次,总剂量46～60Gy,热疗1周2次,间隔72h.观察近期疗效及不良反应.结果 54例肝癌患者治疗后,完全缓解（CR）13例（24.1%）;部分缓解（PR）35例（64.8%）;稳定（NC）4例（7.4%）;进展（PD）2例（3.7%）;总有效率（CR＋PR）为88.9%（48/54）.治疗后AFP均有不同程度的下降.1、2、3年生存率分别为77.8%、59.3%、40.7%.结论 TACE联合3-DCRT及热疗治疗中晚期原发性肝癌具有较好的疗效,不良反应无明显增加.

Objective To evaluate the efficacy and side effects of transcatheter arterial chemoembolization（TACE） com- bined with three-dimensional conformal radiotherapy （3-DCRT） and hyperthermia on advanced primary hepatic carcinoma（PHC）. Methods A total of 54 patients were treated with TACE, followed by hyperthermia, and then 3-DCRT. All patients underwent TA- CE 1 - 2course and 3-DCRT of 46 - 60Gy were performed after 4 weeks interval of TACE. Results There were 13 cases with CR （24. 1% ） ,35 cases with PR（64. 8% ） ,4 cases with NC（7.4% ）and 2 cases with PD（3.7% ） in 54 cases,the total effective rate （ CR ＋ PR） was 88.9%. The 1,2,3year survival rates were 77.8% , 59. 3% ,40. 7%. Conclusions TACE combined with 3- DCRT and hyperthermia is more effective for advanced PHC ,without increasing side effects.