肝动脉介入化疗结合三维适形放疗治疗原发性和转移性肝癌的临床研究

A Clinical Study of Transcatheter Arterial Chemoembolization Combined with Three-dimensional Conformal Radiotherapy in Liver Cancer

目的 探讨肝动脉介入化疗结合三维适形反应 ,治疗原发性肝癌和转移性肝癌的疗效。方法 对符合入组条件的 2 4例肝癌患者 ,先采用肝动脉介入化疗 1～ 3次 ,再进行三维适形放疗 ,肿瘤剂量 2Gy/次 ,1次 /天 ,5天 /周 ,剂量范围 (5 0± 9)Gy。放疗结束后 1个月进行疗效评价 ,应用WHO分度标准评价不良反应。结果 PR 3例 ,MR 6例 ,SD 15例 ,无CR、PD病例。肝功能异常 1例 ,上消化道出血 3例 ,Ⅰ～Ⅱ度骨髓功能抑制 16例 ,发热 1例。结论 肝动脉介入化疗结合三维适形放疗对原发性和转移性肝癌是安全。

Objective To evaluate the response and tolerance of patients with intrahepatic malignancies treated by three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization.Methods Twenty-four patients with primary hepatocellular carcinoma and lung,gallbladder,colorectal,breast,pancreas and nasopharynx metastases were enrolled in the present study.All patients underwent transcatheter arterial chemoembolization(TACE).At an interval of about one month,conformal radiotherapy was given.Radiation was given five times a week at 2 Gy per day.Radiation dose to the target volume was 50±9 Gy.The response was assessed one month after the completion of treatment.The toxicity of therapy were evaluated by criterion of WHO.Results Partial response was observed in 3 patients and minimal response in 6 patients.Stable disease was observed in 15 patients.Neither complete response nor progressive disease was observed.One patient developed radiation-induced liver disease.The gastrointestinal bleeding occurred in three patients.Grade 1～2 leucopenia,anaemia and thrombocytopenia were observed in 16 patients(16/24),5 patients(5/24) and 6 patients(6/24) respectively.One patient developed fever.Conclusion Three-dimensional conformal radiotherapy combined with Transcatheter arterial chemoembolization is a safe and effective treatment for liver cancer.