原发性肝癌伴门静脉癌栓的放射治疗研究

Radiation Therapy of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

目的探讨立体定向适形放疗联合介入治疗对原发性肝癌伴门静脉癌栓的治疗效果及其应用的价值。方法2012年8月至2014年8月我科收治37例肝癌伴门静脉癌栓患者行肝动脉插管化疗(介入)+立体定向适形放疗,与同期单纯介入肝癌癌栓患者(45例)比较,研究两组间肿瘤缓解率、1年生存率、总体生存时间等差异。结果立体定向适形放疗+介入较之单纯介入治疗,能有效控制杀灭肿瘤细胞,有效控制肿瘤生长(59.45%vs.31.11%,P<0.05),显著提高1年生存率(29.73%vs.8.89%,P<0.05)。结论立体定向适形放疗+介入是治疗肝癌伴门静脉癌栓的有效手段,可以显著改善预后,延长总体生存时间。

Objective To investigate the therapeutic effect of stereotactic conformal radiotherapy combined with transhepatic arterial chemotherapy and embolization( TACE) in the treatment of hepatocellular carcinoma( HCC) with portal vein tumor thrombus( PVTT) and the value of its application. Methods From August 2012 to August 2014,37 patients of HCC with PVTT underwent stereotactic conformal radiotherapy combined with TACE,compared with 45 patients only accepted TACE.The remission rate,1 year survival rate and overall survival time were analyzed in this study between two groups. Results The stereotactic conformal radiotherapy and TACE can control tumor cells proliferation and the growth of tumor more effectively( 59. 45% vs. 31. 11%,P < 0. 05),improve the 1 year survival rate more significantly( 29. 73% vs. 8. 89%,P < 0. 05)than,that of the TACE group. Conclusion Stereotactic conformal radiotherapy combined with TACE therapy is an effective method for treatment of HCC with PVTT. It can improve the prognosis and prolong the overall survival time.