三维适形放疗联合肝动脉化疗栓塞治疗晚期肝癌疗效分析.docVIP

三维适形放疗联合肝动脉化疗栓塞治疗晚期肝癌疗效分析[摘要] 目的：探讨三维适形放疗（3-DCRT）联合肝动脉化疗栓塞（TACE）治疗晚期肝癌的临床疗效。方法：将近年收治的采用TACE、3-DCRT联合治疗晚期肝癌患者41例作为观察组，同期单纯TACE治疗者41例作为对照组，比较两组患者的近期临床疗效，毒副反应发生情况。结果：观察组患者中治疗前34例甲胎蛋白升高，对照组中33例甲胎蛋白升高，经治疗后，观察组中30例患者甲胎蛋白下降，对照组24例患者甲胎蛋白下降，两组比较差异有统计学意义（P0.05）。结论：三维适形放疗可确实提高肝动脉化疗栓塞法治疗晚期肝癌的疗效，且并不增加患者的毒副反应发生率，值得临床推广应用。 [关键词] 三维适形放疗；肝动脉化疗栓塞；晚期肝癌；甲胎蛋白 [中图分类号] R735.7 [文献标识码] B [文章编号] 1673-7210（2011）11（c）-182-03 Analysis of therapeutic effect about advanced hepatocellular carcinoma treated by 3-DCRT combined with TACE NIE Chenyang Division of Medical Affairs, General Hospital of Guangzhou Military Command Hospital Affiliated One Hundred and Fifty-Seventh Hospital, Guangdong Province, Guangzhou 510510, China [Abstract] Objective: To investigate the clinical effect of the advanced hepatocellular carcinoma treated by 3-DCRT combined with TACE. Methods: 41 patients of advanced hepatocellular carcinoma treated by 3-DCRT combined with TACE in the recent years were regarded as observation group, 41 patients treated by TACE were taken as control group. The short-term clinical effect, toxic and adverse reaction of the two groups were compared. Results: AFP in 34 patients of the observation group were increased and 33 patients of the control group were increased before treatement. After the treatements, the AFP of 30 patients of the observation group were decreased, 24 patients of the control group were decreased, which showed significant differences between the two groups (P0.05). Conclusion: The 3-DCRT can improve the curative effect of TACE indeed, and it can’t increase the incidence of the toxic and adverse reaction. [Key words] 3-DCRT; TACE; Advanced hepatocellular carcinoma; AFP 原发性肝细胞癌是临床常见的恶性肿瘤，在我国，其发病率居世界首位，预后差，病死率高，有文献报道，伴有门静脉瘤栓的患者占原发性肝癌患者的 62.2%~90.2%[1]。其生存期平均仅为2.7个月。无门静脉瘤栓者生存期平均为24.4个月[2]。治疗原发性肝癌的首选治疗方法为手术切除，但是因其起病隐匿，早期无明显症状，至发现时约有80%的患者已为晚期肝癌，失去手术机会[5]。肝动脉化疗栓塞（TACE）是目前治疗晚期肝癌的首选治疗方法，其临床疗效已得到临床肯定，但为了提高患者临床生存期，需寻找一种更为高效的疗法。三维适形放射治疗（D3-CRT）是一种新发展起来的精确放疗技术，可