TACE结合体部γ-刀治疗原发性肝癌的临床观察  

Clinical study of transcatheter arterial chemoembolization combined with γ-knife for primary hepatic carcinoma

作　　者：周培华[1] 萧勇[1] 王怀碧[2] 

机构地区：[1]重庆市中医院放射科,重庆400021 [2]重庆市中医院肿瘤科,重庆400021

出　　处：《西部医学》2011年第7期1284-1286,共3页Medical Journal of West China

摘　　要：目的探讨经导管肝动脉栓塞化疗术(TACE)结合γ刀治疗原发性肝癌的疗效并和单纯TACE治疗进行疗效比较。方法 56例不能手术的肝癌患者随机分为介入加γ刀放疗组(TACE+SBRT组)与单纯介入组(TACE组)。22例行单纯TACE治疗;TACE+SBRT组34例先行碘油、奥沙利铂、羟基喜树碱、丝裂霉素、5-氟尿嘧啶、明胶海绵等经肝动脉化疗栓塞1～3次后,再进行γ刀放疗,用50%等剂量线包绕靶区,处方剂量为400～450cGy/次,共计10～13次,6次/周,肿瘤边缘总剂量达45～52Gy。结果治疗后TACE+SBRT组3个月总有效率(近期疗效)为79.4%,1、3、5年生存率分别为82.3%、52.9%和20.6%;TACE组3个月总有效率(近期疗效)为50.0%,1、3、5年生存率分别为59.1%、31.8%和9.1%,两组生存率比较有显著性差异(P<0.05)。结论 TACE结合γ刀是原发性肝癌疗效较好的局部治疗方式,优于单纯TACE。Objective To observe the reponse and tolerance of patients with primary hepatic carcinoma（PHC） treated by gamma knife combined with transcatheter arterial chemoembolization（TACE） and compare the efect of TACE alone with that of TACE combined with stereotactic body radio therapy（SBRT） for patients with primary hepatic carcinoma.Methods A total of 56 patients with HCC were randomly divided into TACE alone group and TACE combined with SBRT group.22 cases of the 56 patients were treated with TACE alone and 34 with TACE plus 3DCRT.34 patients were treated with TACE firstly,TACE was performed using lipiodol,Oxaliplatin,HCPT,MMC,5-FU,followed by gelatinspong cubes,gamma ray conformal radiotherapy was performed after 1-3 times TACE was given,50% isodose include PTV,dosage of 400-450cGy/fractions,6 times one week,a total of 10-13 fractions was used,total dose intumor margins was 45-52Gy.Results The total effective rate after three months and overall survival rates after 1,3,5 years in TACE combined with SBRT group（79.4%,82.3%,52.9%,20.6%）were significantly higher than that in TACE alone group（50.0%,59.1%,31.8%,9.1%）（P0.05）.Conclusion TACE combined with γ-knife is an effective local treatment for the primary hepatocellular carcinoma.The therapeutic effect with TACE combine SBRT much is better than TACE alone.

关 键 词：肝癌 介入化疗栓塞 伽玛射线 立体定向放射治疗 

分 类 号：R735.7[医药卫生—肿瘤]