经导管肝动脉化疗栓塞联合三维适型放疗治疗肝癌的临床研究
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[摘要] 目的：探讨经导管肝动脉化疗栓塞(TACE)联合三维适型放疗(3D-CRT)治疗肝癌的疗效。方法：收集60例原发性或转移性肝癌患者，随机分为联合治疗组和对照组，分别采用TACE联合3D-CRP或TACE治疗，随访1年后评估患者治疗效果、不良副作用和中位生存时间。结果：TACE联合3D-CRP治疗组患者总疗效率、中位生存时间均优于TACE组，且不良副作用较少。结论：TACE联合3D-CRP治疗肝癌患者疗效较好，不良副作用少，值得临床推广。
[关键词] 经导管肝动脉化疗栓塞；三维适型放疗；肝癌；临床研究
[中图分类号] R730.58[文献标识码]B [文章编号]1674-4721(2011)06(b)-128-03
Clinical research of hepatic-carcinoma therapy with transcatheter arterial chemo-embolization combining with the three dimensional conformal radiotherapy
LIN Xiaohui
Shenzhen Baoan District People's Hospital, Guangdong Province, Shenzhen 518101, China
[Abstract] Objective: To investigate the therapeutic efficacy of hepatic-carcinoma with transcatheter arterial chemo-embolization (TACE) combinating with the three dimensional conformal radiotherapy (3D-CRT). Methods: Sixty patients diagnosed as primary or metastatic hepatic-carcinoma were enrolled and randomly assigned into combinative therapeutic group and control group which were treated with TACE combined with 3D-CRP or TACE respectively. After one year followed up, overall therapeutic efficacy, adverse side effect and median survival time were evaluated. Results: Overall therapeutic efficacy and median survival time were superior in combinative group over control group, while adverse side effects incidence were less in combinative group than control group. Conclusion: TACE combinating with 3D-CRT has well efficacy and less adverse side effects incidence on hepatic-carcinoma therapy and the combinative therapy deserves to be clinical application broadly.
[Key words] Transcatheter arterial chemo-embolization; Three dimensional conformal radiotherapy; Hepatic-carcinoma; Clinical research
世界范围内，每年约有26万例患者死于肝癌，其中我国每年约有11万例患者死于肝癌，其死亡率占我国恶性肿瘤的第3位[1]。既往大量流行病学资料表明我国原发性肝癌患者多由病毒性肝炎或肝硬化发展而来，确诊时80%左右患者均错过了外科手术治疗时机，因此，非外科手术治疗方法成为现阶段治疗晚期肝癌患者的重要手段之一[2]。目前临床常用且有效的方法是经导管肝动脉化疗栓塞(transcatheter arterial chemo-embolization，TACE)，但由于肝癌组织部分有门静脉供血，且对于部分小肝癌，采用TACE治疗效果欠佳，因此，有学者采用TACE联合放疗治疗经TACE治疗后效果欠佳患者，其结果表明联合治疗可以在一定程度上提高肝癌患者的临床疗效[3-4]。三维适型放疗(three dimensional conformal radiotherapy ......
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