放疗联合肝动脉栓塞化疗治疗大肠癌肝转移的疗效观察

Efficacy of Radiotherapy Combined with Transcatheter Arterial Chemoembolization in Treatment of Liver Metastasis of Colorectal Cancer

目的评价放疗联合肝动脉栓塞化疗（TACE）对大肠癌肝转移患者的疗效。方法将2009年1月至2012年10月在永州市中心医院就诊的52例大肠癌肝转移患者，采用随机数字表法分为研究组（26例）和对照组（26例）。所有患者均进行TACE治疗2次（奥沙利铂85mg／m^2，亚叶酸钙200mg／m^2，氟尿嘧啶1000mg／m^2），研究组继续进行三维适形放疗，对照组只进行TACE治疗。观察患者近期疗效。放化疗期间观察白细胞减少、恶心、呕吐、手足综合征、发热、腹痛、周围神经炎、转氨酶升高等不良反应。记录患者无进展生存期。结果研究组近期有效率为69．2％（18／26），对照组为38．5％（10／26），研究组近期有效率显著高于对照组（P〈0．05）；所有患者化放疗不良反应均为Ⅰ～Ⅱ度，两组不良反应发生率比较差异无统计学意义（P〉0．05）；研究组患者中位无进展生存期为38周，对照组为29周，两组中位无进展生存期差异有统计学意义（P〈0．05）。结论放疗联合TACE能提高大肠癌肝转移患者的近期疗效，延长无进展生存期，不增加不良反应，安全性高。

Objective To evaluate the efficacy of radiotherapy combined with transcatheter arterial ehemoembolization（TACE） for patients with liver metastasis of colorectal cancer. Methods Fifty-two patients of colorectal cancer with liver metastasis in Yongzhou Central Hospital from Jan. 2009 to Oct. 2012 were divided into a research group （26 cases） and a control group （26 cases ）, according to the random number table method. All patients underwent TACE treatment for two cycles （oxaliplatin 85 mg/m2, leucovorin 200 mg/m2 ,and fluorouracil 1000 mg,/m2 ）, and the research group proceeded with 3DCRT, while the control group was treated only with TACE. Observe the short-term effects of patients. During the treatment, we observed adverse reactions, all chemotherapy and radiotherapy toxicities were Ⅰ - Ⅱ degree, including leukopenia, nausea, vomiting, hand-foot syndrome, fever, abdominal pain, peripheral neuritis, elevated transferases. Recorded progression free survival time. Results The recent efficacy of the research group was 69.2% （ 18/ 26 ）, of the control group was 38.5 % （10/26）, there was significant difference between the two groups （P 〈 0.05 ）. During the treatment, all chemotherapy and radiotherapy toxicities were degree Ⅰ - Ⅱ , and there were no significant differences between the two groups（ P 〉 0. 05 ）. The median PFS of the research group was 38 weeks,of the control group was 29 weeks, there was significant difference between the two groups （ P 〈 0. 05）. Conclusion Radiotherapy combined with TACE is effective in treatment of colorectal liver metastasis which can significantly improve the PFS with high safety,without increasing the adverse reactions.