摘要
目的：分析肝动脉栓塞化疗（TACE）联合立体定向放射治疗（SBRT）不能手术的原发性肝癌的疗效及毒副反应。方法：96例不能手术的原发性肝癌患者,TACE联合SBRT治疗44例（研究组）,单纯TACE治疗52例（对照组）。TACE灌注化疗药物为：氟尿嘧啶（5-FU）（1 000-1 500）mg和/或顺铂[DDP（40-60）mg],表阿霉素（E-ADM）（30-50）mg,栓塞剂为超乳化碘油（3-18）ml。SBRT采用月亮神立体定向伽玛射线旋转聚焦全身放射治疗系统,≥50%等剂量线包绕PTV,单次剂量3-6Gy,5次/周,照射总量30-50Gy。结果：研究组和对照组的TACE平均次数分别为2.0（1-6）和3.6（1-7）。中位生存期分别为18.1个月和10.6个月。两组2年局部控制率分别为42.5%、32.8%,3年局部控制率分别为35.8%、22.5%,两组比较有显著的统计学意义（P=0.044,P=0.040）。2年生存率分别为40.5%、29.2%,3年生存率分别为32.2%、20.3%,2年、3年总生存率比较两组均有统计学差异（P=0.048,P=0.032）。研究组发现2例放射诱发的肝病。结论：TACE联合SBRT比单纯TACE对不能手术的原发性肝癌治疗疗效好,毒副反应未增加。
Objective To analyse the therapeutic effects and side - effect of the transcatheter arterial chemoembo- lization（ TACE） combined with stereotactic body radiation therapy （SBTR） for patients with unresectable hepatocel-lular carcinoma. Methods：All 96 cases of advanced hepatocellular carcinoma were divided into 2 groups,44 cases in therapy group treated with TACE and SBTR,52 cases in control group treated with TACE alone. For TACE,（ 30 - 50） mg epimbicin,（ 1 000 -1 500） mg 5 - fluorouracil and/or （40 ？ 60） mg cisplatin were perfused into the hepatic arter- ies,（ 3 -18 ） ml iodized oil was given to emobolized the hepatic arteries. For SBRT,LUNA - 260 whole body - gamma knife radiosurgery was used, 50% isodose curve included PTV,and the total treatment dose was 30 - 50Gy/5 -12f ,5 times per week. Average dose of liver 〈 23Gy, F30 〈 30% . Results ： For therapy group and control group, average TACE were 2. 0（ 1 - 6） and 3. 6（ 1 - 7） times. Medium survival time（ MST） were 18. 1 and 10. 6 months respectively. The 2 years local control rates were 42. 5% and 32. 8% respectively,and 3 years local control rates were 35. 8% ,22. 5% （P =0. 044 ,P = 0. 040） . For therapy group,2 and 3 years survival rates were 40. 5% and 32. 2% respectively, and for control group, they were 29. 2% and 20. 3% respectively. All of them showed a statistically significant differences for 2 and 3 years survival rates（P = 0. 048 ,P = 0. 032）. There were 2 cases with radiation induced liver disease（ RILD） in therapy group. Conclusion： The efficacy of TACE combined with SBRT is superior to that of TACE alone for advanced hepatocellular carcinoma. The side - effect is moderate and clinical acceptable.
出处
《现代肿瘤医学》
CAS
2016年第21期3437-3440,共4页
Journal of Modern Oncology
