摘要
目的探讨伽玛刀和经皮肝动脉化疗栓塞（TACE）序贯治疗原发性肝癌伴门静脉癌栓的临床疗效和不良反应。方法将2004年2月至2008年3月收治的101例原发性肝癌伴门脉癌栓患者随机分为3组,A组34例,先给予伽玛刀治疗,之后予TACE治疗;B组37例,先给予TACE治疗,之后予伽玛刀治疗;C组30例,单纯行伽玛刀治疗。结果 101例患者治疗3个月的有效率为87.1%（88/101）。A、B两组之间的有效率、中位生存期、局部控制率、生存率、门脉癌栓有效率、AFP改善率及腹胀、腹部不适改善率比较,差异均无统计学意义（P〉0.05）,但均优于C组（P〈0.05）。B组肝功能恶化率高于A组（P〈0.05）,而A组和C组比较差异无统计学意义（P〉0.05）。全组患者随访5~36个月,未见严重并发症。结论对伴门静脉癌栓的原发性肝癌采用伽玛刀联合TACE治疗的疗效较好,先给予伽玛刀治疗再行TACE对肝功能影响较小。
Objective To study the influence of the sequence of gamma knife（γ-knife） and transarterial chemoembolization（TACE） on the efficacy and toxicity for the treatment of hepatocellular carcinoma（HCC） with portal vein tumor thrombosis（PVTT）.Methods A total of 101 patients who were diagnosed as primary HCC with PVTT were enrolled in this studied from February 2004 to March 2008 and were randomly divided into three groups： group A of 34 patients were treated with γ-knife followed by TACE,group B of 37 patients were treated with TACE followed by γ-knife,and group C of 30 patients were treated with γ-knife alone.Results The total efficacy rate after 3-month treatment was 87.1%（88/101）.The efficacy rates,survival rates,AFP remission rates,the improvement of abdominal distention and abdominal discomfort of groups A and B were not significantly different（P0.05）,but were better than those of group C（P0.05）.The exacerbation rate of liver function of group B was higher than that of group A（P0.05）,while this rate of group A was not significantly different from group C（P0.05）.No serious complication was found in the follow-up period.Conclusion The combination of γ-knife and TACE is a relatively effective local treatment for primary HCC patients with PVTT.Compared with TACE followed by γ-knife,γ-knife followed by TACE may cause a negative influence on the liver function.
出处
《临床肿瘤学杂志》
CAS
2011年第7期617-621,共5页
Chinese Clinical Oncology
关键词
原发性肝癌
门静脉癌栓
伽玛刀
经皮肝动脉化疗栓塞
Primary hepatocellular carcinoma
Portal vein tumor thrombosis（PVTT）
γ-knife
Transcatheter arterial chemoembolization（TACE）
