原发性肝癌合并门静脉及下腔静脉癌栓调强放疗的疗效及预后分析

黄龙; 祁亮; 黎功

doi:10.3969/j.issn.1001-5256.2015.06.015

原发性肝癌合并门静脉及下腔静脉癌栓调强放疗的疗效及预后分析

DOI: 10.3969/j.issn.1001-5256.2015.06.015

安徽医科大学武警总医院临床学院肿瘤二科

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中图分类号: R735.7
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出版历程
- 出版日期: 2015-06-20

Therapeutic effect and prognostic analysis of intensity-modulated radiotherapy for primary hepatocellular carcinoma with portal vein and / or inferior vena cava tumor thrombus

摘要

摘要:
目的评价调强放射治疗原发性肝癌合并门静脉及下腔静脉癌栓的临床疗效及预后影响因素。方法收集2008年4月至2011年8月安徽医科大学武警总医院肿瘤中心收治的23例原发性肝癌合并门静脉及下腔静脉癌栓患者,应用8 MV直线加速器对行调强放射治疗。单次剂量36 Gy,5次/周,总照射剂量5696 Gy,中位剂量60 Gy。记录生存期,评估不良反应。生存率及生存分析采用Kaplan-Meier法,2组间计数资料的比较采用χ2检验。结果 1例患者因上消化道出血未完成放疗。22例接受调强放射治疗患者完全缓解4例,部分缓解10例,总有效率为63.7%。分析显示,肿瘤缓解率与癌栓类型、肿瘤大小有关（P<0.05）,是影响预后的显著性因素。中位生存时间13.43个月,1、2、3年生存率分别为59%、27%、18%。22例完成放射治疗患者没有出现急性放射性损伤,未出现放射性肝病等晚期不良反应。结论调强放射治疗对原发性肝癌合并门静脉及下腔静脉癌栓患者是一个安全、有效的选择。
- 肝肿瘤 /
- 门静脉 /
- 腔静脉,下 /
- 放射疗法,调强适形
Abstract:
Objective To determine the efficacy and prognostic factors of intensity- modulated radiotherapy( IMRT) for primary hepatocellular carcinoma( HCC) with portal vein and / or inferior vena cava tumor thrombus. Methods Twenty- three HCC patients with portal vein and / or inferior vena cava tumor thrombus received IMRT with an 8 MV linear accelerator at the Cancer Center of General Hospital of Armed Police Forces,Anhui Medical University,from April 2008 to August 2011. A single dose of 3 to 6 Gy was delivered at five fractions per week,with a total dose of 56 to 96 Gy and a median dose of 60 Gy. Survival time was recorded,and adverse reactions were evaluated. Survival rate calculation and survival analysis were performed using the Kaplan- Meier method. Comparison of categorical between two groups was made by chi- square test. Results One patient did not complete radiotherapy due to upper gastrointestinal bleeding. Of 22 patients who completed IMRT,4 achieved complete remission and 10 achieved partial remission,with an overall response rate of 63. 7%. Our analysis showed that the type of tumor thrombus and tumor size were associated with tumor response rate and were significant prognostic factors( P< 0. 05). The median survival time was 13. 4 months. The 1-,2-,and 3- year survival rates were 59%,27%,and 18%,respectively. The 22 patients who completed radiotherapy did not experience acute radiation injury or late adverse outcomes such as radiation- induced liver disease. Conclusion This study suggests IMRT is a safe and effective treatment option for HCC patients with portal vein and / or inferior vena cava tumor thrombus.
- liver neoplasms /
- portal vein /
- vena cava,inferior /
- radiotherapy,intensity-modulated

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参考文献(16)

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