三维适形放射治疗中晚期原发性肝癌的近期疗效观察

Three-dimensional conformal radiotherapy for advanced primary hepaic carcinomas.

目的 分析三维适形放射治疗中晚期原发性肝癌的近期疗效。方法 对 13例中晚期原发性肝癌(均为大肝癌 ,其中Ⅱ期 3例 ,Ⅲ期 10例 )采用每周 3次 ,隔日一次 ,每次 3～ 6GY ,DT2 6 5～ 47 5GY 8～ 11次 19～ 2 2d的分割方式进行三维适形放疗。疗效按WHO实体瘤客观评价判定标准进行。结果 1例疗中死于上消化道出血。 12例完成治疗 ,其中PR1例 ,MR4例 ,SD6例 ,PD1例。生存时间 2 5 - 3 0个月 ,中位生存期 8个月。带瘤生存 1例 ,已生存 3 0个月。死亡 11例 ,其中 1例死于上消化道出血 ,1例死于化疗并发症 ,其余 9例死于恶液质。结论 DT2 6 5～47 5GY 8～ 11次 19～ 2 2d ,每次 3～ 6GY的分割方式患者可以很好耐受 ;三维适形放射治疗对中晚期原发性肝癌有较好的姑息治疗作用 ,能够延长中晚期原发性肝癌的生存期。

Objective To evaluate the value of three-dimensional conformal radiotherapy (3-DCRT) for advanced hepatic carcinoma.Methods Between April 1999and April 2001, 13 patients were treated with 3-DCRT. All patients were treated with 3～6 GY fractions to a total dose of 26 5～47 5 GY/8～11 fractions/19～22 days. Results one patient died of upper gastrointestinal hemorrhage during the treatment. Of 12patients who accomplished the treatment, there were PR1/12(8%), MR4/12(33%), SD6/12 (50%), and PD1/12(8%). The survival time was 2 5 to 30 months. The median survival time was 8 months. one patient has being survival for 30 months. Of 11died patients, 9 died of upper gastrointestinal hemorrhage, complications of chemotherapy and dyscrasia respectively. Conclusion The method mentioned above is appropriate for advanced primary hepatic carcinomas and can prolong the survival time.