大分割三维适形放疗联合经导管动脉化疗栓塞治疗不能手术原发性肝癌临床研究  

Clinical study of hyper-fractionated three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for treating patients with inoperable primary livercancer

作　　者：高宗毅[1] 张继宝[2] 刘江涛[1] 刘永利[1] 

机构地区：[1]山东省滨州市中心医院放疗中心,山东251700 [2]山东省滨州市中心医院肿瘤科,山东251700

出　　处：《中国医师进修杂志》2012年第17期11-14,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：探讨大分割三维适形放疗（3DcRT）联合经导管动脉化疗栓塞（TAcE）治疗不能手术原发性肝癌的临床疗效。方法102例不能手术切除的中晚期原发性肝癌患者按随机数字表法分为两组，对照组49例，采用TACE治疗，观察组53例，采用大分割3DCRT联合TACE治疗，定期检查，判断两组患者近期疗效，调查患者1、2、3年生存率、不良反应以及治疗后血清甲胎蛋白（AFP）的表达情况。结果观察组患者完全缓解率、进展率、总有效率分别为17．0％（9／53）、11．3％（6／53）、73．6％（39／53），对照组分别为2．0％（1／49）、28．6％（14／49）、51．0％（25／49），两组比较差异有统计学意义（P＜0．05）。两组不良反应比较差异无统计学意义（P＞0．05）。对照组1、2、3年的生存率分别为51．O％（25／49）、28．6％（14／49）、14．3％（7／49），中位生存期为15个月；观察组分别为71．7％（38／53）、52．8％（28／53）、39．6％（21／53）、20个月。观察组2、3年生存率明显高于对照组，差异有统计学意义（P＜0．05或＜0．01）。观察组血清AFP阳性患者治疗前后无明显变化率为9．8％（4／41），与对照组的31．6％（12／38）比较差异有统计学意义（P＜0．05）。结论大分割3DCRT联合TACE治疗不能手术原发性肝癌的临床疗效好，值得在临床中推广。Objective To investigate the clinical effect of hyper-fractionated three-dimensional conformal radiotherapy （3DCRT） combined with transcatheter arterial chemoembolization （TACE） for treating patients with inoperable primary liver cancer. Methods One hundred and two patients with inoperable advanced primary liver cancer were divided by random digits table method into control group with 49 cases treated with TACE and observation group with 53 eases treated with hyper-fractionated 3DCRT combined with TACE. The short-term efficacy, adverse reaction and survival rate of the 1 st, 2nd and 3rd year and serum alpha-fetoprotein （AFP） expression after treatment in two groups were observed. Results The complete remission rate, progress rate and total efficiency were 17.0% （9/53）, 11.3% （6/53）, 73.6% （39/53） in observation group, 2.0% （ 1/49 ）, 28.6% （ 14/49 ）, 51.0% （ 25/49 ） in control group. There were significant differences between two groups （P〈 0.05 ）. There was no statistical significance in adverse reactions between two groups （P 〉 0.05 ）. The survival rates of the lst,2nd and 3rd year in control group were 51.0%（25/49）, 28.6% （14/49）, 14.3%（7/49）,the median survival time was 15 months;while those in observation groupwere 71.7% （38/53）, 52.8% （28/53）, 39.6% （21/53） and 20 months. The survival rates of the 2nd and 3rd year in observation group were significantly higher than those in control group respectively （P 〈 0.05 or 〈 0.01 ）. The rate of patients with no obvious serum AFP protein change between observation group [9.8% （4/41 ） ] and control group [ 31.6% （ 12/38 ） ] had statistical significance （P 〈 0.05 ）. Conclusion Hyper- fractionated 3DCRT combined with TACE for treating patients with inoperable primary liver cancer has good clinical efficacy, it is worthy of clinical practice.

关 键 词：肝肿瘤 化学栓塞 治疗性 甲胎蛋白类 三维适形放疗 

分 类 号：R735.7[医药卫生—肿瘤]