摘要
目的:探讨肝动脉栓塞术化疗(TACE)后联合调强放射治疗(IMRT)对不能手术的原发性肝癌的临床疗效。方法:回顾分析2002年5月至2008年5月期间住院治疗的64例不能手术的中晚期原发性肝癌患者,放疗前给予TACE1～2个疗程,TACE后间隔2周左右给予调强放疗。观察近期疗效、急性不良反应及预后因素。结果:全组35例患者完全缓解2例、部分缓解39例、疾病稳定4例、疾病进展1例,总有效率为78.5%。1年生存率为79.2%,2年生存率为48.5%,3年生存率为30%,全组患者的中位生存时间为24.8个月。急性不良反应均可耐受。单因素分析显示大体肿瘤体积(GTV)、放疗分次剂量、放疗总剂量对近期疗效有影响,有统计学差异(P<0.05)。结论:TACE联合IMRT对不能手术切除的原发性肝癌具有较好的疗效,且不良反应可以耐受。GTV、放疗分次剂量、放疗总剂量是影响患者生存的独立预后因素。
Objective To evaluate clinical therapeutic effctiveness of transarterial chemo-embolization （TACE） combined with intensity modulated radlation treatment （IMRT） in unresectable hepatocellular carcinoma（HCC）. Methods Retrospectively analyzed 46 patients with unresectable hepatocellular carcinoma were proved by pathology from May 2002 to May 2008, before irradiation TACE 1 - 2 treatment, TACE interval of 2 weeks after giving intensity modulated radiation treatment. The effect of treatment, acute adverse effects and prognostic factor for survival were evaluated. Results 46 patients with complete remission was 2 cases, 39 cases of partial remission, stable disease in 4 cases, i case of disease progression, the total effective rate was 78.5%. I year survival rate was 79.2%, 2-year survival rate was 48.5%, 3-year survival rate was 30% for all patients, the median survival time was 24.8 months. Acute adverse reactions were tolerable. The univariate analyses showed gross tumor volume（GTV）, fractional dose, and total dose were prognostic factors（P〈0.05）. Conclusions TACE combined with IMRT for unresectable hepatocellular carcinoma reveals a better therapeutic effect, and adverse reactions can be tolerated. GTV, fractional dose and total dose were independent prognostic factor for survival.
出处
《求医问药（下半月刊）》
2012年第4期288-289,共2页
Seek Medical and Ask The Medicine
