立体定向放射治疗联合中药治疗原发性大肝癌的临床研究  

Whole-body γ-knife radiotherapy combined with Chinese herbal drugs to treat large primary liver cancer

作　　者：庞军[1] 陈浩涛[1] 陈燕[1] 郝光远[2] 张明星[3] 凡蓉 杨新中[5] 李长青[1] 

机构地区：[1]武警湖北省总队医院伽玛刀中心,武汉430061 [2]武警湖北省总队医院影像科 [3]武警湖北省总队医院胸外科 [4]武警湖北省总队医院肿瘤科 [5]武警湖北省总队医院中医肿瘤科

出　　处：《中国癌症防治杂志》2012年第2期158-162,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：武警湖北省总队后勤部湖北省总队医院科研项目(2011013)

摘　　要：目的探讨全身γ刀立体定向放射治疗联合中药治疗原发性大肝癌的疗效及毒副反应。方法将2009年7月至2011年2月我院收治的100例符合入选条件的原发性大肝癌患者随机分为治疗组(48例)和对照组(52例)。治疗组予体部伽玛刀加中药治疗。采用超级γ刀(SGS-I型)立体定向放射治疗,根据肿瘤的位置、临床靶体积和患者的身体状况与治疗目的,制定放射治疗计划及调整剂量分布。肿瘤体积55.9～2579.0cm3,等剂量曲线50%～60%,周边照射总剂量33～40Gy,分割处方剂量3.3～5.0Gy,重复治疗8～12次,5次/周。中药治疗采用中药协定1号处方和2号处方加减,1号处方(党参、葛根、白术、黄芩等21味)用于伽玛刀治疗中和治疗后半月内,以健脾和胃、清热理气为主,辅以化瘀、补肾等;2号方(党参、葛根、白术、柴胡等21味)在伽玛刀治疗后半月开始,至少服用2～3月,以健脾和胃、疏肝理气为主,辅以化瘀、抗癌等。对照组予体部伽玛刀治疗,方法同前。结果两组患者治疗后2～3个月行CT或MR复查,肿瘤控制总有效率分别为95.83%和94.23%,6个月和1年生存率分别为75.00%、71.15%和60.42%、57.69%。差异均无统计学意义(P>0.05)。在提高患者生活质量、减轻临床症状和改善肝功能方面差异有统计学意义(P<0.05)。结论全身γ刀立体定向放射治疗原发性大肝癌临床疗效确切,毒副反应较轻。联合中药治疗可以提高患者生活质量、减轻放疗不良反应。Objective To investigate the clinical application and short-term effects of stereotactic whole-body γ-knife radiotherapy combined with Chinese herbal drugs to treat patients with large primary liver cancer. Methods A total of 100 patients with large primary liver cancer hospitalized from July 2009 to February 2011 were randomly divided into a treatment group and control group.The treatment group was treated with whole-body γ-knife radiotherapy combined with Chinese herbal drugs.Stereotactie super-γ-knife radiotherapy was carried out 4-12 times,5 times per week（tumor size,55.9-2579.0 cm3;isodose curve,50%-60%;total radiation dose, 33-40 Gy ;fractional dose,3.3-5.0 Gy）.Treatment with Chinese herbal drugs（prescription No. 1 ）was carried out during radiotherapy or for 2-3 months after the radiotherapy.Prescription No.2 was used for 2-3 months after radiotherapy.The control group was treated with only stereotactic super-γ-knife radiotherapy.Therapeutic effects and side effects of the two treatments were analyzed. Results The overall response rates at 3 months after treatment were 95.83% in the treatment group and 94.23% in the control group.The treatment group showed 6-month and γ-year survival rates of 75.00% and 71.15% ,compared to 60.42% and 57.69% for the control group.The two groups did not differ significantly in curative effects（P〉0.05）,whereas they did differ significantly in adverse reactions（P〈0.05）. Conclusion Stereotactic super-γ-knife radiotherapy is effective for treating large primary liver cancer, and the combination of wholebody γ-knife with Chinese herbal drugs can improve quality of life significantly and reduce the adverse reactions due to radiotherapy.

关 键 词：原发性大肝癌 全身伽玛刀 立体定向放射治疗 中医药 

分 类 号：R734.7[医药卫生—肿瘤]