摘要
目的:探讨肝动脉化疗栓塞(TACE)联合三维适形放射治疗(3-DRCT)在治疗不能手术切除的原发性肝癌(HCC)的疗效。方法:将90例不能手术切除的HCC患者分为两组,实验组(B组)行1次TACE后再给以立体定向放疗,对照组(A组)根据病情给以TACE2-3次。比较两组肿瘤大小、AFP变化情况,并对1,2,3年生存率进行分析。结果:A组治疗前后平均肿瘤直径分别是(7.35±2.25)cm和(6.20±1.67)cm,B组分别是(7.65±1.86)cm和(6.18±1.74)cm,两组治疗前、后比较均有显著差异(t分别为2.681和3.891,P<0.005和P<0.001),但两组之间比较均没有显著差异(P>0.05)。两组治疗前后血清AFP水平比较两组均有明显下降,A组从2596.0 ng/L下降到246.9 ng/L(U=420,P<0.001),B组从2317.4 ng/L下降到64.6 ng/L(U=310.0,P<0.001)。两组之间比较,治疗后AFP差异有统计学意义(U=561.0,P<0.05)。两组中位生存期分别为18月和25月,1、2、3年生存率分别为:A组66.7%,42.2%和25%,B组为86.7%,55.6%和33.3%,两组比较差异有显著性意义(P=0.01)。结论:TACE联合3-DRCT治疗不能切除的HCC的疗效优于单纯TACE。
Objective：To evaluate the therapeutic effect of combined transcatheter arterial chemoembolization（TACE） and three dimensional conformal radiotherapy（3-DRCT） for hepatocellular carcinoma（HCC）.Methods：Ninety patients with HCC were randomly divided into 2 groups.Forty-five patients（group A） received TACE（2-3 procedures） and other received treatment of combination of TACE（1 procedure） and 3-DRCT（group B,n=45）.The tumor size and serum AFP level between the two groups were compared.The 1-,2-,3-year cumulative survival rates of the patients were analyzed.Results：The average diameter of tumor before and after treatment were（7.35±2.25）cm and（6.20±1.67）cm in group A respectively.The tumor diam-eter before and after treatment were（7.35±2.25）cm and（6.20±1.67）cm in group B respectively.There was statistically signifi-cant decrease in tumor size in both group A（t = 2.681,P 〈0.005） and group B（t = 3.891,P 〈0.001）.There was no significant differences between the two groups in tumor response（P 〉0.05）.Mean serum AFP level was significant decreased in group A（from 2596.0 ng/L to 246.9 ng/L） and group B（from 2317.4 ng/L to 64.6 ng/L）.Significant differences was demonstracted be-tween the two groups after treatment（U = 561.0,P 〈0.05）.The median survival period in group Aand B were 18 months and 25 months.The cumulate survival rate of 1,2 and 3-year were 66.7%,42.2% and 25% in group A and 86.7%,55.6% and 33.3% in group B.Significant differences was exhibited（P = 0.01）.Conclusions：The therapeutic effect of TACE combined with 3-DRCT is better than single TACE in the treatment of unresectable HCC.
出处
《中国医学物理学杂志》
CSCD
2010年第5期2084-2086,共3页
Chinese Journal of Medical Physics
关键词
肝细胞癌
立体定向放射治疗
经导管动脉化疗栓塞术
hepatocellular carcinoma
stereotactic radiotherapy
transcatheter arterial chemoembolization
