IMRT联合HIFU治疗手术及TACE术后复发原发性肝癌的临床研究  

Clinical research of IMRT combined with HIFU for inoperatable recurrent primary hepatic carcinoma after operation and TACE

作　　者：许涛[1] 景红霞[2] 李林均[1] 张军[1] 余建云[1] 程雄飞[1] 焦娇[1] 

机构地区：[1]湖北医药学院附属人民医院肿瘤中心,湖北十堰442000 [2]湖北医药学院附属人民医院超声科,湖北十堰442000

出　　处：《重庆医学》2016年第36期5088-5090,5094,共4页Chongqing medicine

基　　金：十堰市科学技术研究与开发项目(16Y46);十堰市人民医院青年英才项目(14-7)

摘　　要：目的：探讨调强放疗（IMRT）联合高强度聚焦超声（HIFU）治疗手术及肝动脉化疗栓塞术（TACE）后复发的原发性肝癌的临床疗效及毒副反应。方法60例手术及TACE术后复发原发性肝癌患者，分为对照组和观察组各30例，观察组行IM‐RT联合HIFU同步治疗，对照组仅行IMRT治疗。两组均采用6MV‐X射线IMRT，总剂量54～70Gy／6～7周。观察组于放疗第1天开始行HIFU，5次／周，共6～7周。结果观察组和对照组近期疗效比较差异有统计学意义（P＜0．05）。两组在急性放射性毒副反应比较差异无统计学意义（P＞0．05）。对照组和观察组1年、2年总生存率分别为72．8％、36．2％和89．9％、78．9％，1、2年无进展生存率分别为64．3％、28．1％和85．9％、50．9％，比较差异均有统计学意义（P＜0．05）。对照组和观察组中位生存时间为24个月和36个月，中位无进展生存时间为17个月和27个月。结论对于不能手术或拒接手术的术后TACE复发原发性肝癌患者，IMRT联合HIFU治疗疗效确切，毒副反应可以耐受，有一定应用价值。Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy（IMRT）combined with high intensity focused ultrasound（HIFU） for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT （5 days/week ,6-7 weeks） .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant （P〈0 .05） ,there was no significant difference in acute radioactive toxicity between the two groups （P〉0 .05） .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant （P〈0 .05）;the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant （P〈0 .05） .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .

关 键 词：原发性肝癌 放射疗法 调强适形 高强度聚焦超声 

分 类 号：R735.7[医药卫生—肿瘤]