三维适形放疗结合TACE在结直肠癌患者根治术后肝转移的临床应用  

Transarterial chemoembolization combined with three-dimensional conformal radiation therapy for liver metastases from colorectal cancer

作　　者：李爽[1,2] 罗海峰[1,2] 蒋代文[1,2] 杨继元[1,2] 

机构地区：[1]长江大学附属第一医院 [2]荆州市第一人民医院肿瘤诊疗中心,湖北荆州434000

出　　处：《现代肿瘤医学》2009年第11期2171-2173,共3页Journal of Modern Oncology

摘　　要：目的:探讨对于不宜或不能手术治疗的结直肠癌肝转移灶行TACE后根治性三维适形放射治疗的可行性,不良反应及疗效。方法:对20例结直肠癌根治术后出现肝转移灶的病人,行TACE(ADM+碘油)后3周内,针对其肝转移灶行三维适形放疗,常规分割2Gy,总剂量60-66Gy。结果:4例(20%)患者出现Ⅲ度恶心呕吐,3例(15%)出现Ⅲ度中性粒细胞减少,1例(5%)出现Ⅲ度血小板减少,4例(20%)出现Ⅲ度肝功能异常。治疗结束后,4例(20%)CR,11例(55%)PR,5例(25%)SD,无1例进展,有效率为75%。结论:对于结直肠癌根治术后出现不宜或不能手术的肝转移癌,应用三维适形放疗结合TACE的治疗模式,是可行的,无严重不良反应,近期疗效显著。[ Abstract] Objective：To evaluate the feasibility and toxicity, and estimate the therapeutic effect of patients with unresectable liver metastases from colorectal carcinoma treated with three - dimensional conformal radiation therapy after TACE. Methods ： Twenty cases of liver metastases from colorectal carcinoma were treated by three - dimensional conformal radiation therapy after TACE, the radiation therapy was delivered as a conventional fractionation regimen （2Gy/day,5 fractions/week ） to a total dose of 60Gy -66Gy. Results：Grade 3 nausea and vomit was seen in 20% of patients;Grade 3 leukopenia occurred in 15% ;Grade 3 thrombocytopenia occurred in 5%. Grad 3 impaired liver function tests occurred in 20%. After the treatment,4 cases （20%） was CR,11 cases （55%） PR,5 cases （25%） SD,no PD. The response rate was 75%. Conclusion：3D - CRT after TACE is a feasible treatment for unresectable liver metastases from colorectal carcinoma, the toxicity is tolerable, and it has a significant short -term effect.

关 键 词：三维适形放疗 肝转移癌 结直肠癌 肝动脉化疗栓塞术 

分 类 号：R730.55[医药卫生—肿瘤]