【摘要】 目的研究三维适形放疗(3DCRT)联合肝动脉化疗栓塞(TACE)对Ⅲ、Ⅳ期原发性肝癌的疗效。方法80例Ⅲ、Ⅳ期原发性肝癌患者随机分为2个组,40例采用3DCRT+TACE,40例采用3DCRT+肝动脉插管药物灌注(HAI)。结果3DCRT联合TACE组与3DCRT联合HAI组有效率分别为75%和45%(P<0·05)。3DCRT+TACE组0·5、1·0、2·0年局部控制率分别为93%、85%、61%,明显高于3DCRT+HAI组的70%、43%、33%(P<0·05)。远处转移率3DCRT+TACE组与3DCRT+HAI组分别为30%和38%(P>0·05)。3DCRT+TACE组0·5、1·0、2·0年生存率分别为73%、45%、28%,高于3DCRT+HAI组的45%、25%、13%(P<0·01)。毒副反应结果显示治疗组与对照组相似(P>0·05)。结论3DCRT+TACE能提高Ⅲ、Ⅳ期原发性肝癌疗效,是中晚期原发性肝癌行之有效的治疗方法。更多还原

【Abstract】 Objective To evaluate the effects of three-dimensional conformal radiation therapy (3DCRT) combined with transcatheter arterial chemoembolization (TACE) on stage Ⅲ/Ⅳ primary hepatic carcinoma. Methods Eighty cases of stage Ⅲ/Ⅳ primary hepatic carcinoma were randomly divided into two groups: 40 cases treated with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization (3DCRT+TACE group) and 40 cases treated with three-dimensional conformal radiation therapy associated with hepatic arterial infusion chemotherapy (3DCRT+HAI group). Results The response rates were 75% and 45% in 3DCRT+TACE group and 3DCRT+HAI group, respectively; and the difference between the two groups was statistically significant (P<0.05). The 0.5-, 1-, and 2-year local response rates were 93%, 85% and 61% in 3DCRT+TACE group, and 70%, 43% and 33% in 3DCRT+HAI group, respectively; and the difference between the two groups was statistically significant (P<0.05). The difference of distant metastasis rates, 30% in 3DCRT+TACE group and 38% in 3DCRT+HAI group, was not statistically significant (P>0.05), The 0.5-, 1- and 2-year survival rates were 73%, 45% and 28% in 3DCRT+TACE group, and 45%, 25% and 13% in 3DCRT+HAI group, respectively; and the difference between the two groups was statistically significant (P<0.01). The difference of side-effect rates between the two groups was not statistically significant (P>0.05). Conclusion Three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization improved prognosis of stage Ⅲ/Ⅳ primary hepatic carcinoma.;更多还原