DEB-TACE联合3D-CRT治疗巨块型肝癌伴门脉癌栓的临床研究

Clinical Study of DEB-TACE Combined with 3D-CRT in the Treatment of Massive Liver Cancer with Portal Vein Cancer Thrombus

目的 探讨载药微球栓塞(drug-carrying microsphere embolization, DEB-TACE)联合三维适形放疗(3D conformal radiotherapy, 3D-CRT)治疗巨块型肝癌伴门脉癌栓的疗效。方法 选取2020年1月—2022年4月在茂名市人民医院接受规范化治疗的巨块型肝癌伴门脉癌栓患者40例,以随机数表法分为两组,每组20例。对照组采用DEB-TACE治疗,研究组采用3D-CRT联合DEB-TACE治疗,对比两组临床疗效。结果 治疗后,研究组侵犯门静脉管壁发生率(60.00%)、不良反应率(20.00%)均低于对照组,差异有统计学意义(χ^(2)=5.161、5.104,P<0.05)。治疗后,研究组的肝功能指标均低于对照组,差异有统计学意义(P<0.05);在术后1个月,研究组的血生化指标水平均低于对照组,差异有统计学意义(P<0.05);在术后6、12、18个月和24个月,两组的无进展生存期比较,差异无统计学意义(P>0.05)。结论 在巨块型肝癌伴门脉癌栓的治疗过程中,3D-CRT联合DEB-TACE有一定的优越性和发展力,是一种高效的治疗方法,具有广泛的社会效益。

Objective To investigate the efficacy of drug-carrying microsphere embolization(DEB-TACE)combined with 3D conformal radiotherapy(3D-CRT)in the treatment of massive liver cancer with portal vein cancer thrombus.Methods A total of 40 patients with massive liver cancer with portal vein cancer thrombus who received standardized treatment in Maoming People's Hospital from January 2020 to April 2022 were selected and divided into two groups by random number table method,with 20 patients in each group.The control group was treated with DEB-TACE,and the study group was treated with 3D-CRT combined with DEB-TACE.The clinical efficacy of the two groups was compared.Results After treatment,the incidence of invasion of portal vein wall(60.00%)and adverse reaction rate(20.00%)in the study group were lower than those in the control group,and the difference was statistically significant(χ^(2)=5.161,5.104,P<0.05).After treatment,the liver function indexes of the study group were lower than those of the control group,the difference was statistically significant(P<0.05).At 1 month after operation,the blood biochemical indexes of the study group were lower than those of the control group,the difference was statistically significant(P<0.05).At 6 months,12 months,18 months and 24 months after surgery,there was no statistically significant difference in progression-free survival between the two groups(P>0.05).Conclusion In the treatment of massive liver cancer with portal vein cancer thrombus,3D-CRT combined with DEB-TACE has certain advantages and development,and is an efficient treatment method with extensive social benefits.