摘要
目的观察介入加X线立体定向放射治疗不能手术的原发性肝癌的疗效和副作用。方法分析我院 1997年 6月至 1999年 7月收治的 36例原发性肝癌行介入加X线立体定向放射治疗的情况 ,采用Seldinger技术穿刺股动脉 ,经肝动脉给予灌注化学药物治疗 (TAI) ,CF 30 0mg,5 FU10 0 0～ 15 0 0mg ,CDDP 6 0～ 80mg ,ADM 6 0～ 80mg(或MMC 10～ 2 0mg)。TAI后或 2次TAI之间给予立体定向放射治疗。分割剂量视情况为 5～ 8Gy ,总次数 5～ 8次不等 ,70 %～ 90 %的等剂量线包括靶区 ,立体定向放疗DT 40～ 5 0Gy。结果 3个月后病变达CR 9例 ,PR 2 5例 ,NR 1例 ,PD 1例 ,总有效率为 94%。 6个月后复查CT示 :CR 11例 ,PR 2 4例 ,NR 0例 ,PD 1例 ,总有效率为 97%。 1年生存率为85 % ,2年生存率为 6 8%。直径 5cm以下癌灶完全缓解 (CR)达 91% (10 / 11) ,5cm以上者CR为 1/ 2 5。10例患者AFP值在治疗后 6个月内下降至正常 ,P <0 0 1。WHOⅠ、Ⅱ级骨髓抑制发生率为 47% ,急性胃肠道放射反应占 5 4%。结论不能切除的原发性肝癌经介入加X线立体定向放射治疗可达到满意的缓解症状 ,延长生存期 。
ObjectiveTo study the effect of transcatheter hepatic arterial infusion (TAI) and stereotaxic radiotherapy (SR) for unresectable liver cancer. MethodsFrom June 1997 to July 1999, TAI and SR were used to treat 36 patients with unresectable liver cancer. The first step was interventional chemotherapy(TAI) which consisted of CF 300?mg,5-FU 1?000～1?500?mg, CDDP 60～80?mg, and ADM 60～80?mg (or MMC 10～20?mg). Stereotaxic radiotherapy was given after two sessions or between the two sessions of TAI. The planned target volume was encompassed by more than 70%～90% isodose line, tumor dose from 5?Gy to 8?Gy per fraction, total number was 5～8 fractions. ResultsThe total effective rate were 94% and 97% judged by CT at 3 and 6 months respectively. The 1-,2-year survival rates were 85% and 68%,respecctively. ConclusionCompared with radiotherapy alone and interventional chemotherapy alone, the combined therapy results in higher therapeutic effect and longer remission time in patients with unresectable liver cancer.
出处
《中华普通外科杂志》
CSCD
北大核心
2002年第4期204-206,共3页
Chinese Journal of General Surgery
