原发性肝癌三维适形放疗联合肝动脉栓塞化疗的近期疗效观察  

Efficacy of three-dimensional conformal radiotherapy combined with hepatic arterial chemoembolization for patients with primary hepatic cancer

作　　者：李工[1] 侯友贤[1] 

机构地区：[1]广州军区广州总医院放射肿瘤中心,广州510010

出　　处：《解放军医学杂志》2007年第7期679-680,共2页Medical Journal of Chinese People's Liberation Army

基　　金：广东省医学科研基金立项课题(A2002535)

摘　　要：目的评估三维立体适形放射治疗(3D-CRT)联合肝动脉栓塞化疗对原发性肝癌的近期疗效。方法2003年7月～2006年7月收治的原发性肝癌患者59例,经3次肝动脉插管栓塞化疗后6周,行CT定位扫描,确定靶区,采用德国Leibinger三维立体适形放射治疗计划系统设计治疗计划,美国Varian600C/D6MeVX线加速器+多叶光栅实施适形非共面多野放疗,总剂量(TD)为60～65Gy/9～11次,15～22天。结果完全缓解(CR)率为57·6%,部分缓解(PR)率为35·6%,无变化(NC)率为3·4%,进展(PD)率为3·4%,总有效(CR+PR)率93·2%。1例在治疗后1周出现黄疸,死于急性肝功能衰竭。结论3D-CRT联合肝动脉栓塞化疗治疗原发性肝癌近期疗效肯定,是一种有效的原发性肝癌综合治疗方法。Objective To evaluate the efficacy of three-dimensional conformal radiotherapy （3D-CRT） combined with transcatheter hepatic arterial chemoembolization （TACE） for patients with primary liver cancer. Methods From July 2003 to July 2006, followed by transcatheter hepatic arterial chemoembolization （TACE, mitomycin ＋ 5-fluorouracil ＋ pirarubicin） 3 times in 6 weeks, 59 patients with primary hepatic cancer received noncoplanarity multifield 3D-CRT by using Leibinger three-dimensional stereotactic conformal radiotherapy planning system, Varian 600C/D 6MeV X liner accelerator and multileaf collimator at a dose of 60-65Gy/9-11 fractions/15-22 days. Results Of 59 patients, 58 cases received a complete course of 3D-CRT combined with TACE. CT results showed that the rates of complete response （CR）, partial response （PR）, no change （NC） and progression （PD） rate were 57. 6% （34/59）, 35. 6% （21/59）, 3. 4% （2/59） and 3. 4% （2/59）, respectively. Overall response rate （CR＋PR） was 93. 2% （55/59）. Jaundice occurred one week after treatment in one patient, who died of acute hepatic function failure. No serious adverse effects or intoxication were found in the remaining 58 patients. Conclusions The combination of 3D-RCT with TACE was an effective treatment for patients with primary hepatic cancer.

关 键 词：肝肿瘤 放射疗法 适形 化学栓塞 治疗性 

分 类 号：R735.705[医药卫生—肿瘤]