摘要
目的探讨不能手术伴有门静脉癌栓（PVTT）的原发性肝癌（PHC）安全而疗效较好的治疗方法,为制定合理的治疗措施提供临床依据。方法 2005年3月~2008年4月期间在本院住院的原发性肝癌合并门静脉癌栓患者共38例,采用肝动脉栓塞化疗（TACE）1~2次后,再以三维适形放疗（3D-CRT）技术给予残留病灶及门静脉癌栓放疗,3~6 Gy/次,每周3次,DT40~55 Gy;放疗期间同步口服希罗达化疗,每3周1个疗程,共1~2个疗程。结果原发灶肿瘤近期有效率69.7%,1年生存率72.7%,2年生存率57.6%。多因素分析显示肿瘤分期、肝功能Child-Pugh分级、卡氏评分是影响预后的主要因素（P〈0.05）。结论口服希罗达联合TACE、3D-CRT治疗原发性肝癌合并门静脉癌栓具有疗效好,损伤小且易耐受,是治疗原发性肝癌并门静脉癌栓有效的治疗方法。
Objective To explore the safe and effective treatment for inoperable primary hepatic carcinoma（PHC） with portal vein tumor thrombus（PVTT）,to provide the clinical basis for the development a reasonable treatment measure.Methods Analyze the clinical data of 38 cases of PVTT From March 2005 to April 2008.The patients were treated with transcatheter arterial chemoembolization（TACE） followed by three-dimensional conformal radiotherapy（3-DCRT） combined with oral xeloda.Results Primary tumors′s hort-term effectire rate（CR＋PR） was 69.7%;The 1-2-year survival rate was 72.7,57.6%.Cox proportional hazards model analysis showed the phase of tumor,Child-Pugh class,Karnofsky grade were the independent prognostic factor for the survival probability of the patients（P0.05）.Conclusions With less damage and less toxicity,capecitabine combined with TACE and 3D-CRT is an effective method in the treatment of portal vein tumor thrombus in hepatocellular carcinoma.
出处
《实用临床医药杂志》
CAS
2011年第1期30-32,共3页
Journal of Clinical Medicine in Practice
关键词
原发性肝癌
门静脉癌栓
三维适形放疗
肝动脉栓塞化疗
希罗达
hepatocellular carcinoma
portal vein tumor thrombus
three-dimensional conformal radiotherapy
transcatheter arterial chemoemolization
Xeloda
