摘要
目的 探讨肝动脉化疗栓塞 (TACE)后采用三维适形放射治疗 (3DCRT)原发性肝癌的疗效。方法 82例肝癌中 41例TACE +3DCRT(综合组 ) ,41例单纯TACE(对照组 )。TACE先将氟尿嘧啶 1 0 0 0～ 1 2 50mg和羟基喜树碱 2 0～ 30mg注入动脉 ,再将顺铂 60～ 80mg和丝裂霉素 1 4～ 2 0mg(或表阿霉素 50～ 60mg)与超液化碘油 1 0～ 30ml充分混合成乳剂注入 ,再用 1～ 2mm明胶海绵颗粒栓塞肝动脉。 2个组TACE均进行 1～ 3次。 3DCRT采用 6MVX射线 ,计划靶体积 (PTV)≤ 2 1 6cm3者单次剂量为 5～ 8Gy ,总剂量为DT4 0～ 56Gy;PTV >2 1 6cm3者单次剂量为 4Gy,总剂量 36～ 44Gy ;二者均隔日 1次。结果 综合组近期有效率 (CR +PR)为 87.8% ,对照组为 58.5 %。两组差异有显著性意义(χ2 =8.94,P <0 .0 1 )。 1、2、3年生存率综合组分别为 73 .2 %、58.7%和 41 .9% ,对照组分别为 54 .8%、2 7.3 %和 1 2 .8% ,两组差异有显著性意义 (χ2 =5 .52 ,P <0 .0 5)。综合组 3DCRT前PTV≤ 2 1 6cm3者与PTV >2 1 6cm3者相比 ,前者 3年生存率大于后者 (53 .8%∶2 0 .0 % ;χ2 =4.72 ,P <0 .0 5)。肝功能A级和B级 3年生存率分别为 56 .3 %和 1 4 .3 % ,差异有显著性意义 (χ2 =5 .49,P <0 .0 5)。结论 TACE
Objective To evaluate the therapeutic efficacy of three dimensional c onformal radiotherapy(3DCRT) plus transarterial chemoembolization(TACE) for unre sectable primary liver cancer. Methods Eighty-two patients with unresectable pr imary liver cancer were rando?mly divided into two groups: 41 were treated with 3 DCRT plus TACE and the rest were treated with TACE alone. For TACE, 1?000-1? 250?mg 5-fluorouracil and 20-30?mg hydroxycamptothecine were perfused into the hepa tic arteries' then 60-80?mg cisplatin and 14～20?mg mitomycin C (or 50-60?mg e pirubicin )and iodized oil 10-30?ml were given to embolized the hepatic arteries which was then followed by 1-2?mm gelform particles. TACE were treated with 1-3 sessio ns i n either group. For 3DCRT,radiation was given by 6 MV X-ray. Patients whose pl an ned target volume(PTV)was smaller than 216?cm 3 received a total dose of 40 -56?Gy , 5-8?Gy per session every other day.Patients whose PTV was larger than 216? cm 3 r eceived a total dose of 36-44?Gy,4?Gy per session every other day. Results The response rate(CR+PR) of 3DCRT plus TACE group and TACE alone group were 87.8% an d 58.5%,with the difference statistically significant (χ 2=8.94,P<0.01). The 1 -,2-,3-year survival rates of 3DCRT plus TACE group and TACE alone group were 73 .2% , 58.7%, 41.9% and 54.8%, 27.3%, 12.8%;also with the difference statistical ly significant (χ 2= 5.52 ,P<0.05). The 3-year survival rate of Child A and Child B were 56.3% and 14.3%, respectively .The difference between the two groups was statistically significant(χ 2=5.49,P<0.05). The main factors affecting the pro gnosis in the 3DCRT plus TACE group were liver function and the size of tumor. Conclusion Combined 3DCRT and TACE is more effective than TACE alone.It can eff ect a longer interval of control and higher survival in patients with unresectab le primary hepatobiliary cancer.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2003年第1期30-32,共3页
Chinese Journal of Radiation Oncology
关键词
适形放射治疗
介入治疗
原发性肝癌
Liver neoplasms/radiotherapy
Liver neoplasms
Embolization,thera peutic
Combined modality therapy
