三维适形放疗治疗原发性肝癌的临床疗效分析

Clinical application of three dimensional conformal radiation therapy in treating primary hepatic carcinoma patients

目的探讨三维适形放疗治疗原发性肝癌的近期疗效与不良反应。方法选取2005年1月至2010年12月间收治的原发性肝癌并进行三维适形放疗的患者45例,处方剂量6MV-X95%计划靶体积(PTV)45Gy,每次1.8Gy;分25次,或62Gy,每次2Gy;分31次,观察患者的疗效。结果45例患者中,完全缓解(CR)率为11.1%(5/45),部分缓解(PR)率为66.7%(30/45),稳定(SD)率为15.6%(7/45),病情进展(PD)率为6.7%(3/45),总有效率为77.8%(35/45)。全组患者1、2、3年的生存率分别为58.3%、36.1%和15.8%,中位生存时间为14.7个月。放疗后放射性肝病(RILD)发生率为2%。结论三维适形放疗对原发性肝癌患者的治疗效果较为满意,可延长中晚期肝癌患者的生存期,并能提高患者的生存质量。

Objective To evaluate the short-term efficacy and the secondary reaction in treating the primary hepatic carcinoma by three dimensional conformal radiation therapy（3D-CRT）.Methods Fourtyfive cases with primary liver carcinoma treated in the Frist Affiliated Hospital of Inner Mongolia Medical University from January 2005 to December 2010 are accepted 3DCRT treatment,and the prescribed dose is6MV-X 95% planning target volume（PTV） 45 Gy /1.8 Gy /25 f ~ 62 Gy /2 Gy /31 f.Results The complete response rate,partial response rate,no change rate,progressive disease rate and response rate of the short-term effort of primary hepatic carcinoma are 11.1%（5 /45）,66.7%（30 /45）,15.6%（7 /45）,6.7%（3 /45） and 77.8%（35 /45）,respectively.The survival rate of 1-year,2-year,3-year are 58.3%,36.1% and 15.8%,respectively.The median survival time is 14.7 mo.The rate of radiation-induced liver disease（RILD） is 2%.Conclusion The effect treating the primary hepatic carcinoma by 3DCRT is acceptable.Radiotherapy can lengthen the survival time and it can also improve the quality of life of patients.