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Observations on the therapeutic effects of γ-ray three dimensional conformal radiation therapy combined with interventional therapy or χ-ray three dimensional conformal radiation therapy combined with interventional therapy in patients with primary hepatocellular carcinoma
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摘要: 目的比较肝动脉介入栓塞化疗（TACE）联合伽玛刀治疗与TACE联合三维适形放射治疗原发性肝癌（HCC）的疗效。方法将50例不能手术的Ⅱa或Ⅱb期HCC患者根据患者意愿和适应证分为TACE+伽玛刀治疗组（A组）25例与TACE+三维适形放射治疗组（B组）25例,两组一般情况无统计学差异。A组先行TACE（40%碘化油+CPDD+5-FU+EADM）治疗2～3次后,再进行体部伽玛刀放射治疗。B组先行2～3次TACE治疗后,再行加速器适形放射治疗。结果治疗后3个月评价疗效,A组RR率（CR+PR）为84%（21/25）,1、2、3年生存率分别为76%,45.9%,20.44%。B组的RR率为56%（14/25）,与A组比较差异有统计学意义（P<0.05）,B组1、2、3年生存率分别为79.6%,30.2%,12.6%,与A组比较差异无统计学意义（P>0.05）。结论与TACE联合适形放射治疗相比,TACE联合伽玛刀治疗HCC具有较高的近期有效率,而两种治疗的1、2、3年生存期差异无统计学意义。Abstract: Objective To evaluate the effect and tolerance of patients with hepatocellular carcinoma (HCC) treated by γ-ray three-dimensional conformal radiotherapy (3-DCRT) combined with interventional therapy or χ-ray Three Dimensional Conformal Radiation Therapy combined with interventional therapy.Methods From June 2005 to June 2008, 50 patients with HCC were randomly divided into γ-ray three-dimensional conformal radiotherapy (3-DCRT) combined with interventional therapy group (n=25) and χ-ray three-dimensional conformal radiotherapy (3-DCRT) combined with interventional therapy group (n=25) .All the 50 cases were firstly treated with TACE.γ-ray 3-DCRT was performed after 2-3 times of TACE in 25 cases and the remaining 25 cases were treated χ-ray 3-DCRT after 2-3 times of TACE.Results The overall response rate of HCC was 84% in TACE combined with γ-ray 3-DCRT group, significantly higher than that in χ-ray 3-DCRT group (56%) (P<0.05) .The total effective rate after three months and overall survival rates after 1, 2, 3 year in TACE combined with γ-ray 3-DCRT group (76% and 45.9%, 20.4%, respectively) , while the other group (79.6%and30.2%, 12.6%, respectively) , P>0.05.Conclusion The overall response rate of HCC in γ-ray 3-DCRT + TACE is better than χ-ray 3-DCRT + TACE for HCC, but the overall survival rates is not significant.
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Key words:
- liver neoplasms /
- radiotherapy /
- nonformal /
- transcatheter arterial chemoembolization /
- gamma rays
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[1]Zhou ZH, Liu LM, Chen WW, et al.Combined therapy oftranscatheter arterial chemoembolisation and three-dimen-sional conformal radiotherapy for hepatocellular carcinoma[J].Br J Radiol, 2007, 80 (951) :194-201. [2]王执民, 曹玮, 张洪新, 等.中晚期肝癌热灌注TAE疗效与毒副作用评估[J].实用放射学杂志, 2003, 19 (3) :258-260. [3]Dawson LA.The evolving role of radiation therapy in hepato-cel-lular carcinoma[J].Cancer Radiother, 2008, 12 (2) :96-101. [4]陈龙华, 官键.单纯性适形放疗中晚期原发性肝癌的疗效评价[J].第一军医大学学报, 2003, 23 (1) :55-57. [5]Dawson LA, Ten Haken RK, Lawrence TS.Partial irradiation ofthe liver[J].Semin Radiat Oncol, 2001, 11 (3) :240-246. [6]夏廷毅.γ (X) -线立体定向放射治疗临床应用规范和治疗进展[J].中国癌症杂志, 2006, 16 (6) :454-458. [7]梁世雄, 蒋国梁, 朱小东, 等.原发性肝癌大分割三维适形放疗的预后因素分析[J].中华肿瘤杂志, 2005, 27 (10) :613-615. [8]花勤亮, 崔艳慧, 李四清, 等.肝动脉化疗栓塞结合三维适形放疗治疗原发性肝癌[J].现代肿瘤医学, 2006, 14 (10) :1266-1269. -
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