【摘要】 目的探讨调强放疗(intensity modulated radiation therapy,IMRT)联合化疗对肝癌合并门静脉癌栓(portal vein tumor thrombus,PVTT)或下腔静脉癌栓(inferior vena cava tumor thrombosis,IVCTT)的治疗效果。方法肝癌合并PVTT或IVCTT患者93例分为观察组50例和对照组43例,观察组采用IMRT联合奥沙利铂治疗,对照组采用IMRT方案治疗。比较2组治疗后3、6、9、12个月受益率、有效率和不良反应发生情况。结果治疗后3、6个月,观察组受益率(78.0%、76.0%)、有效率(42.0%、40.0%)与对照组(79.1%、67.4%,34.9%、30.2%)比较差异均无统计学意义(P>0.05);治疗后9个月,观察组受益率(68.0%)与对照组(58.1%)比较差异无统计学意义(P>0.05),有效率(36.0%)高于对照组(23.3%)(P<0.05);治疗后12个月,观察组受益率(60.0%)、有效率(28.0%)均高于对照组(37.2%、14.0%)(P<0.05);观察组Ⅰ～Ⅱ级和Ⅲ～Ⅳ级周围神经毒性(30.0%、6.0%)发生率高于对照组(0、0)(P<0.05),血液学毒性(50.0%、36.0%)、消化道反应(60.0%、18.0%)发生率与对照组(46.5%、25.6%,41.9%、7.0%)比较差异无统计学意义(P>0.05)。结论 IMRT联合奥沙利铂治疗肝癌合并PVTT或IVCTT可提高患者长期疗效,安全性良好。更多还原

【Abstract】 Objective To evaluate the effect of intensity modulated radiation therapy(IMRT)combined with chemotherapy on hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT)or inferior vena cava tumor thrombosis(IVCTT).Methods Ninety-three patients with HCC were divided into observation group(n=50)and control group(n=43).Observation group was treated by IMRT plus oxaliplatin,while control group was treated by IMRT.The benefit rate,effective rate and adverse reactions in 3,6,9 and 12 months after treatment were compared between two groups.Results In 3 and 6 months after treatment,there were no significant differences in the benefit rates(78.0%,76.0%)and effective rates(42.0%,40.0%)in observation group in comparison with those in control group(79.1%,67.4%;34.9%,30.2%)(P>0.05).In 9 months after treatment,the benefit rate showed no significant difference between observation group(68.0%)and control group(58.1%)(P>0.05),and the effective rate was significantly higher in observation group(36.0%)than that in control group(23.3%)(P<0.05).In 12 months,the benefit rate and effective rate were significantly higher in observation group(60.0%,28.0%)than those in control group(37.2%,14.0%)(P<0.05).There were no significant differences in the incidences of grade Ⅰ-Ⅱ and Ⅲ-Ⅳhematotoxicity(50.0%,36.0%)and gastrointestinal adverse reaction(60.0%,18.0%)in observation group in comparison with those in control group(46.5%,25.6%,41.9%,7.0%)(P>0.05),and the incidences of peripheral neurotoxicity were significantly higher in observation group(30.0%,6.0%)than those in control group(0,0)(P<0.05).ConclusionIMRT plus chemotherapy is safe and has long-term effect on HCC with PVTT/IVCTT.更多还原