用三维适形放疗治疗肝癌切除术后肺转移病灶的指征和疗效

Indication and efficacy of 3-dimensional conformal radiation therapy for pulmonary metastasis of primary hepatic cancer

目的 归纳总结采用三维适形放疗治疗原发性肝癌切除术后单纯肺转移病灶的指征和疗效。方法 回顾性分析近 3年 2 1例采用三维适形放疗技术治疗原发性肝癌切除术后单纯肺转移病灶的适应证、方法及疗效 ,并与同期1 2例采用放射介入治疗病人进行比较分析。结果 本组病例中采用三维适形放疗 2 1例 ,随访 1 8个月 ,肺转移癌有效控制率、缩小率、消失率分别是 1 0 0 %、62 .0 %和 38.1 %。血清甲胎蛋白经历了术后的正常 -升高 -降低 -再升高 -再正常的过程。而同期介入治疗组 1 2例 ,随访 1 8个月 ,肺转移癌有效控制率、缩小率、消失率分别是 58.3 %、41 .7%和 1 6 .7% ,P <0 .0 1。结论 三维适形放疗能够明显地控制和杀灭原发性肝癌切除术后出现的肺转移病灶 ,延长病人的存活时间 ,其疗效优于介入治疗组。仅存在肺部转移病灶而无肝内复发和转移 。

Objective To summarize indication and efficacy of pulmonary metastasis of primary hepatic cancer treated by 3 dimensional conformal radiation therapy (3 DCRT).Methods 21 cases of single pulmonary metastasis of primary hepatic cancer treated by 3 DCRT were retrospectively analyzed and their indication,clinical symptoms and efficiency were listed after compared with control group.Results 21 cases of single pulmonary metastases received 3 DCRT for 1～2 courses and AFP experienced normal ascending descending re ascending re normal.Pulmonary metastasis controlling rate,decreasing rate,disappearing rate in 3 DCRT group and in radio intervention therapy group were 100%,62.0%,38.1% and 58.3%,41.7%,16.7% respectively,P<0.01.Conclusion Pulmonary metastasis in patients without hepatic recurrence of primary liver carcinoma could be effectively controlled by 3 DCRT which is obviously superior to radio interventional therapy.