【摘要】 目的探讨三维适形放疗(3DCRT)联合超声聚焦刀(HIFU)治疗肝癌的疗效。方法将原发性肝癌68例,随机分为HIFU+3DCRT组和手术组,各34例。HIFU+3DCRT组:应用三维适形放疗(3DCRT)联合声像图引导定位、实时监控超声聚焦刀(HIFU)治疗。3DCRT采用15MV X射线,计划靶体积(PTV)<125 cm3者单次剂量4～6 Gy,5次/周,总DT 45～56 Gy;PTV≥125 cm3者单次剂量2～4 Gy,5次/周,总DT45～60 Gy。超声聚焦刀治疗5次/周。手术组:采用手术治疗。结果 HIFU+3DCRT组:CR 24例(70.59%),PR 9例(26.47%),NC 1例(2.94%),PD 0例(0),总有效率(CR+PR)为97.06%。手术组:CR 32例(94.12%),PR 2例(5.88%),NC 0例(0),PD 0例(0),总有效率(CR+PR)为100.0%。HIFU+3DCRT组12、、3年生存率分别为91.18%(31/34),85.29%(29/34)、58.82%(20/34),手术组12、、3年生存率分别为97.06%(33/34)、94.12%(32/34)8、2.35%(28/34)。两组近期疗效比较差异无统计学意义(χ2=1.01<3.84,P>0.05)。两组1年生存率比较差异无统计学意义(χ2=1.06<3.84,P>0.05);两组2年生存率比较差异无统计学意义(χ2=1.43<3.84,P>0.05);两组3年生存率比较差异有统计学意义(χ2=4.53>3.84,P<0.05)。结论应用三维适形放疗联合超声聚焦刀治疗早期肝癌近期疗效好,超声能准确有效地引导焦点定位、实时疗效监控及治疗后的疗效评价。更多还原

【Abstract】 Objective To evaluate the effect of high intensity focused ultrasound(HIFU) combined with 3dimensional conformal radiotherapy(3D-CRT) for primary hepatic carcinoma.Methods 68 patients with primary hepatic carcinoma were randomly divided into two groups.In 3D-CRT combined with HIFU group,34 patients received 3D-CRT combined with HIFU.3DCRT was given by 15MV Xray.The patients with planned target volume(PTV) <125 cm3 received a total dose of 45～56 Gy,4～6 Gy per fraction,and the patients with PTV>125 cm3 received a total dose of 45～60 Gy,2～4 Gy per fraction,5 times every week.HIFU treated with 5 times every week.In surgery group patients received traditional radical surgery.Results In 3D-CRT combined with HIFU group:CR 24cases(70.59%),PR 9 cases(26.47%),NC 1case(2.94%),PD 0 case(0),the total cure rate(CR+PR)was 97.06%,the 1-、2-and 3-year survival rates were 91.18%(31/34),85.29%(29/34)、58.82%(20/34),respectively.In surgery group:CR 32 cases(94.12%),PR 2 cases(5.88%),NC 0 case(0),PD 0 case(0),the total cure rate(CR+PR)was 100.00%,the 1-、2-and 3-year survival rates respectively were 97.06%(33/34),94.12%(32/34)、82.35%(28/34).There was no significant difference in CR+PR,1-、and 2-year survival rates(P>0.05),There was significant difference in 3-year survival rate(P<0.05).Conclusion 3DCRT combined with HIFU have good effective for the patients with early primary hepatic carcinoma,Ultrasonography can exactly direct focus field.CDFI is reliable for real-time surveillance.更多还原