原发性肝癌三维适形放疗联合介入治疗的临床研究  

Treatment of primany hepatic carcinoma with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization

作　　者：吴莉[1] 文小平[1] 黄薇[1] 

机构地区：[1]贵阳医学院附属医院肿瘤科,500004

出　　处：《中华放射医学与防护杂志》2006年第3期256-258,共3页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的研究三维适形放疗(3DCRT)联合肝动脉化疗栓塞(TACE)对Ⅲ、Ⅳ期原发性肝癌的疗效。方法80例Ⅲ、Ⅳ期原发性肝癌患者随机分为2个组,40例采用3DCRT+TACE,40例采用3DCRT+肝动脉插管药物灌注(HAI)。结果3DCRT联合TACE组与3DCRT联合HAI组有效率分别为75%和45%(P<0·05)。3DCRT+TACE组0·5、1·0、2·0年局部控制率分别为93%、85%、61%,明显高于3DCRT+HAI组的70%、43%、33%(P<0·05)。远处转移率3DCRT+TACE组与3DCRT+HAI组分别为30%和38%(P>0·05)。3DCRT+TACE组0·5、1·0、2·0年生存率分别为73%、45%、28%,高于3DCRT+HAI组的45%、25%、13%(P<0·01)。毒副反应结果显示治疗组与对照组相似(P>0·05)。结论3DCRT+TACE能提高Ⅲ、Ⅳ期原发性肝癌疗效,是中晚期原发性肝癌行之有效的治疗方法。Objective To evaluate the effects of three-dimensional conformal radiation therapy （3DCRT） combined with transcatheter arterial chemoembolization （TACE） on stage Ⅲ/Ⅳ primary hepatic carcinoma. Methods Eighty cases of stage Ⅲ/Ⅳ primary hepatic carcinoma were randomly divided into two groups： 40 cases treated with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization （3DCRT ＋ TACE group） and 40 cases treated with three-dimensional conformal radiation therapy associated with hepatic arterial infusion chemotherapy （3DCRT ＋ HAl group）. Results The response rates were 75% and 45% in 3DCRT ＋ TACE group and 3DCRT ＋ HAl group, respectively; and the difference between the two groups was statistically significant （P 〈 0.05）. The 0.5-, 1-, and 2-year local response rates were93%, 85% and 61% in 3DCRT ＋ TACE group, and 70%, 43% and 33% in 3DCRT ＋ HAl group, respectively; and the difference between the two groups was statistically significant （ P 〈 0.05）. The difference of distant metastasis rates, 30% in 3DCRT＋ TACE group and 38% in 3DCRT ＋ HAl group, was not statistically significant （P 〉0.05）, The 0.5-, 1- and 2-year survival rates were 73% , 45% and 28% in 3DCRT ＋ TACE group, and 45%, 25% and 13% in 3DCRT ＋ HAl group, respectively; and the difference between the two groups was statistically significant （ P〈0.01 ）. The difference of side-effect rates between the two groups was not statistically significant （P 〉 0.05）. Conclusion Three-dimensional conformal radiation therapy combined with transeatheter arterial chemoembolization improved prognosis of stage Ⅲ/Ⅳ primary hepatic carcinoma.

关 键 词：肝肿瘤/放射疗法 放射疗法 适形 肝肿瘤/化学疗法 栓塞 治疗性 灌注 治疗性 

分 类 号：R735.7[医药卫生—肿瘤]