介入联合放射治疗与介入治疗原发性大/巨大肝癌的比较

Comparison Between Interventioral Therapy Combined With Radiotherapy and Interventional Therapy for Primary Huge Liver Cancer

目的探讨经肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合放射治疗(放疗)治疗原发性大/巨大肝癌的疗效。方法 2013年1月~2014年6月我科对30例原发性大/巨大肝癌行TACE联合三维适形或调强放疗,肿瘤放疗剂量达60 Gy/30次(治疗组),与同期35例原发性大/巨大肝癌行单纯TACE(对照组)进行比较。结果治疗组有效率63.3%(19/30),显著高于对照组37.1%(13/35)(χ~2=4.433,P=0.035)。治疗组1、2、3年生存率分别是76.7%、53.3%和23.3%,对照组分别是62.9%、25.7%和11.4%,治疗组累积生存率显著高于对照组(χ~2=3.967,P=0.046)。治疗组二期手术切除率为26.7%(8/30),显著高于对照组5.7%(2/35)(χ~2=3.957,P=0.047)。2组毒副作用可耐受。结论TACE联合放疗是原发性大/巨大肝癌的一种有效方法,毒副作用可耐受,可延长生存期。

Objective To evaluate the treatment efficiency of transcatheter arterial chemoembolization（ TACE） combined with radiotherapy for the treatment of huge liver cancer. Methods From January 2013 to June 2014,a total of 30 cases of huge liver cancer were treated with TACE and 3 D conformal intensity modulated radiotherapy,with a total dose of over 60 Gy/30 times（ treatment group）. They were compared with another 35 cases treated with interventional therapy（ control group）. Results The effective rate（ CR ＋ PR） of the treatment group was 63. 3%（ 19/30）,which was significantly higher than the control group[37. 1%（ 13/35）,χ~2=4. 433,P = 0. 035]. The survival rate of 1,2,and 3 years were 76. 7%,53. 3%,and 23. 3% in the treatment group and 62. 9%,25. 7%,and 11. 4% in the control group. The cumulative survival rate was significantly higher in the treatment group than that in the control group（ χ~2= 3. 967,P = 0. 046）. The two-stage surgical resection rate was 26. 7%（ 8/30） in the treatment group,which was significantly higher than that in the control group [5. 7%（ 2/35）,χ~2= 3. 957,P = 0. 047]. The toxic and side effects were tolerable in both groups. Conclusion TACE combined with radiotherapy can significantly raise the effective rate and survival rate,and its toxic and side effects are tolerable.