摘要
目的:分析肝动脉栓塞化疗(TACE)联合放射治疗对不能手术的原发性肝癌的疗效与不良反应。方法:2010年1月至2012年12月TACE联合放疗治疗25例原发性肝癌患者(治疗组),单纯TACE治疗原发性肝癌27例(对照组)。TACE选择肝脏肿瘤供血血管,注入氟尿苷500-1000mg和/或顺铂40-60mg,吡柔比星20-40mg+碘化油5-20ml混悬剂,大肝癌合用明胶海绵1/3条,剪成碎末栓塞血管。研究组TACE 1-2次后2-3周,行三维适形放疗,总剂量DT 30-60Gy/15-30f,1.8-2Gy/(f·d),5次/周。结果:治疗组25例共计TACE术60次,平均2.4(1-6)次,完成总剂量DT 30-60Gy/15-30f,2例患者的远处转移灶同时放疗;对照组27例共计TACE术83次,平均3.07(1-8)次。52名患者均可评价疗效。治疗组与对照组的有效率为88.0%和25.9%,中位生存时间为22和5个月,平均生存时间为(14.62±1.86)和(7.47±1.29)个月,组间差异非常显著(P=0.0024)。6、12、18、24个月生存率有显著性差异(P<0.05)。52例患者栓塞化疗并发症有呕吐8例,腹痛16例,发热18例,3例出现Ⅳ度白细胞抑制,无肝肾功能损害,放疗期间未观察到毒副反应。结论:TACE联合放射治疗较单纯TACE对晚期原发性肝癌疗效好,毒副反应未增加。
Objective：To analyse therapeutic effect and side - effect on the combined transcatheter arterial chemo-embolization（TACE）and radiotherapy for advanced primary liver cancer. Methods：All 52 cases of advanced liver cancer were divided into two groups. Therapy group 25 cases were treated by TACE combined radiotherapy,control group 27 cases by TACE. The median surviral time（MST）,12,24 - months survival rate and average survival time （AST）between two groups were compared. Results：In therapy group and controlgroup,average TACE were 2. 4（1 - 6）and 3. 07（1 - 8）times,RR was 88% and 25. 9% ,MST was 22 and 5 months,AST was（14. 62 ± 1. 86）and（7. 47 ± 1. 29）months（P = 0. 0024）,12,24 - months survival rate were（54. 31 ± 10. 95）% and（19. 94 ± 7. 91）% , （45. 26 ± 12. 31）% and（10. 64 ± 6. 51）%（P 〈 0. 05）. Among 52 cases of TACE,complication were 8 cases of vomiting,abdominal pain of 16 cases,fever 18 of cases. Adverse reactions included 3 cases of Ⅳ degree neutropenia inhibition. There was no side - effect of radiotherapy. Conclusion：The efficacy of TACE combined radiotherapy is su-perior to that of TACE. The side - effect is moderate. It is an effective therapy for advanced liver cancer.
出处
《现代肿瘤医学》
CAS
2015年第9期1258-1261,共4页
Journal of Modern Oncology
基金
上海交通大学医学院附属新华医院崇明分院院级重点科研项目资助(编号:YZ-201002)
关键词
原发性肝癌
肝动脉化疗栓塞术
放射治疗
primary liver cancer
transcatheter arterial chemoembolization
radiotherapy
