调强放疗联合化疗在肝癌合并静脉/下腔静脉癌栓中的应用

Application of intensity-modulated radiotherapy combined with chemotherapy in hepatocellular carcinoma complicated with venous/inferior vena cava tumor thrombus

目的探讨在肝癌合并静脉/下腔静脉癌栓患者治疗中使用调强放疗联合化疗的临床治疗效果。方法选取100例肝癌合并静脉/下腔静脉癌栓患者作为研究样本,以随机数字表的方式分为实验组及对照组,各50例。实验组采用调强放疗联合化疗进行治疗,对照组给予调强放疗进行治疗。比较两组患者的临床治疗效果,不良反应发生情况,治疗前后的生活质量评分及心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]评分。结果实验组有效率60.00%高于对照组的30.00%(P<0.05)。两组患者不良反应发生率比较,无统计学差异(P>0.05)。治疗后,实验组社会功能、情绪功能、角色功能、躯体功能评分分别为(90.08±4.21)、(91.27±3.16)、(91.68±5.23)、(92.89±6.19)分,均显著高于对照组的(79.61±3.42)、(78.12±6.15)、(77.26±6.12)、(78.46±5.13)分(P<0.05)。治疗后,对照组SDS及SAS评分分别为(51.72±5.51)、(53.01±4.36)分,实验组分别为(40.21±3.53)、(40.01±5.32)分,实验组均低于对照组(P<0.05)。结论肝癌合并静脉/下腔静脉癌栓患者应用调强放疗联合化疗效果明显,不仅能够改善患者的生存质量,缓解不良心理,同时不会增加不良反应,建议临床大力推广。

Objective To explore the clinical effect of intensity-modulated radiotherapy combined with chemotherapy in hepatocellular carcinoma complicated with venous/inferior vena cava tumor thrombus.Methods A total of 100 patients with liver cancer and venous/inferior vena cava tumor thrombus were selected as study samples and divided into an experimental group and a control group according to random numerical table,with 50 cases in each group.The experimental group was treated with intensity-modulated radiotherapy combined with chemotherapy,and the control group was treated with intensity-modulated radiotherapy.The clinical effects,occurrence of adverse reactions,quality of life scores and psychological state[self-rating anxiety scale(SAS)and self-rating depression scale(SDS)]scores before and after treatment were compared between the two groups.Results The effective rate of the experimental group was 60.00%,which was higher than the control group's 30.00%(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the scores of social function,emotional function,role function and physical function of the experimental group were(90.08±4.21),(91.27±3.16),(91.68±5.23)and(92.89±6.19)points,which were significantly higher than(79.61±3.42),(78.12±6.15),(77.26±6.12)and(78.46±5.13)points in the control group(P<0.05).After treatment,the scores of SDS and SAS in the control group were(51.72±5.51)and(53.01±4.36)points,and those in the experimental group were(40.21±3.53)and(40.01±5.32)points;the experimental group was lower than the control group(P<0.05).Conclusion The application of intensity-modulated radiotherapy combined with chemotherapy has a significant effect on patients with liver cancer complicated with venous/inferior vena cava tumor thrombus.It can not only improve the quality of life of patients,alleviate adverse psychology,but also not increase adverse reactions.it is recommended to be vigorously promoted in the clinic.