化疗栓塞联合质子放射治疗肝癌合并门脉主干癌栓的临床应用  

Interventional chemoembolization combined with proton radiotherapy for the treatment of hepatocellular carcinoma accompanied with portal cancerous thrombus

作　　者：李强[1] 曾从俊[1] 王莺[1] 

机构地区：[1]上海交通大学医学院苏州九龙医院影像科,苏州215021

出　　处：《介入放射学杂志》2009年第4期278-280,共3页Journal of Interventional Radiology

摘　　要：目的探讨栓塞化疗联合质子放射治疗肝癌合并门脉主干癌栓的临床效果。方法46例肝癌合并门静脉癌栓患者,接受介入栓塞化疗与质子联合治疗,将质子放射治疗分程并与介入治疗交替进行。评价其近期疗效、放射反应、随访生存率。结果有效率91.3%,门脉癌栓消失率45.6%,肝功能恢复良好,AFP水平显著下降;放疗中或放疗后无一例发生明确的急慢性放射性肝损伤或放射性肝病;1、6个月,1、2年生存率分别为100%、89.1%、52.2%、21.4%,中位生存期17.6个月。结论对于合并门脉癌栓形成的晚期肝癌患者,介入联合质子放射治疗是一种新的安全有效方法。Objective To evaluate the interventional chemoembolization combined with proton radiotherapy in the treatment of hepatocellular carcinoma （HCC） accompanied with cancerous thrombus in the main portal vein. Methods Interventional chemoembolization combined with proton radiotherapy was performed in 46 patients of HCC accompanied with cancerous thrombus in the main portal vein. The proton radiotherapy was broke up into several fractions. The patients were treated with interventional chemoembolization and, alternatively, with proton radiotherapy. The short-term effectiveness and radiation reaction were evaluated. The survival rate was followed up. Results The effective rate was 91.3%. Disappearance of cancerous thrombus in the main portal vein was seen in 45.6% of patients. The liver functions were well restored, with a remarkable reduction in AFP. No acute or delayed radiation-induced hepatic damage or radiation hepatopathy occurred during the course of and after radiotherapy. The survival rate at 1, 6, 12 and 24 months was 100%, 89.1%, 52.2% and 21.4% respectively, with a median survival period of 17.6 months. Conclusion For the patients of HCC accompanied with cancerous thrombus in the main portal vein, interventional chemoembolization combined with proton radiotherapy is an effective, safe and newly-developed therapy.

关 键 词：癌 肝细胞 门静脉癌栓 栓塞 治疗性 质子 放射疗法 

分 类 号：R735.7[医药卫生—肿瘤]