目的:探討經(jīng)導(dǎo)管肝動脈灌注化療栓塞(TACE)與TACE聯(lián)合三維適形放射治療(TACE + 3DCRT)原發(fā)性肝細胞癌(HCC)的療效.方法:隨機分成兩組的HCC患者,均不能手術(shù)、門脈無癌栓、無遠處臟器轉(zhuǎn)移。50例患者行單純TACE 2次(TACE組)。40例患者在TACE 2次后第四周再行三維適形放射治療(TACE + 3DCRT組),放療采用6MVX射線,4～6 Gy/次,隔日一次,3次/周,總劑量45～60 Gy。TACE采用碘化油、順鉑、5氟尿嘧啶、表阿霉素及明膠海綿。結(jié)果:TACE組與TACE+3DCRT組近期療效有效率(完全緩解+部分緩解)分別為68.0%(34/50)、87.5%(35/40),1年生存率分別為78.0%(39/50)、95.0%(38/40),兩組差異均有統(tǒng)計學(xué)意義(P lt;0.05)。TACE的治療反應(yīng)主要為栓塞綜合征,3DCRT有7.5%(3/40)發(fā)生急性放射性肝炎,經(jīng)對癥、保肝處理后緩解。兩組患者均能耐受。結(jié)論:TACE + 3DCRT治療不能手術(shù)、門脈無癌栓、無遠處臟器轉(zhuǎn)移的HCC的療效較單純TACE治療HCC的療效好。
引用本文： 趙彩霞,任勇軍,文世民,潘榮強. 介入治療聯(lián)合適形放射治療原發(fā)性肝細胞癌的療效分析. 華西醫(yī)學(xué), 2009, 24(7): 1686-1689. doi: 復(fù)制
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| 11. | 鄧瑜萍, 楊志剛, 謝建國,等. 原發(fā)性肝癌介入治療并發(fā)癥原因分析和對策[J]. 華西醫(yī)學(xué), 2006, 21(2):298-299. |
| 12. | KIM T H, KIM D Y, PARK J W, et al. Dosevolumetric parameters predicting radiationinduced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with threedimensional conformal radiotherapy [J]. Int J Radiat Oncol Biol Phys, 2007, 67(1):225-231. |
- 1. TAIEB J, BARBARE J C, BOUSSAHA T, et al. Management of hepatocellular carcinoma. Where are we now? What’s next? [J] Bull Cancer, 2009, 96(1):19-34.
- 2. ZENG W, GOUW A S, VAN DEN HEUVEL M C, et al. The angiogenic makeup of human hepatocellular carcinoma does not favor vascular endothelial growth factor/angiopoietindriven sprouting neovascularization [J]. Hepatology, 2008,48(5):1517-1527.
- 3. LUBIENSKI A, SIMON M, LUBIENSKI K, et al. Update on chemoinfusion and chemoembolization treatments.Radiologe [J]. 2007,47(12):1097-1106,1108.
- 4. WANG B, XU H, GAO Z Q, et al. Increased expression of vascular endothelial growth factor in hepatocellular carcinoma after transcatheter arterial chemoembolization. Acta Radiol [J]. 2008,49(5):523529.
- 5. MIRAGLIA R, PIETROSI G, MARUZZELLI L, et al.Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma. World J Gastroenterol [J]. 2007, 13(21):2952-2955.
- 6. LIANG S X, ZHU X D, XU Z Y,et al. Radiationinduced liver disease in threedimensional conformal radiation therapy for primary liver carcinoma:the risk factors and hepatic radiation tolerance [J]. Int J Radiat Oncol Biol Phys, 2006, 65(2):426-434.
- 7. TSE R V, HAWKINS M, LOCKWOOD G, et al. Phase I study of individualized stereotactic body radiotherapy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma [J]. J Clin Oncol, 2008, 26(4):657-664.
- 8. IGAKI H, NAKAGAWA K, SHIRAISHI K, et al.Threedimensional conformal radiotherapy for hepatocellular carcinoma with inferior vena cava invasion [J]. Jpn J Clin Oncol. 2008, 38(6):438-444.
- 9. CHIAHSIEN CHENG J, CHUANG VP, CHENG SH, et al. Unresectable hepatocellular carcinoma treated with radiotherapy and/or chemoembolization [J]. Int J Cancer, 2001, 96(4):243-252.
- 10. LI B, YU J, WANG L, et al. Study of local threedimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for patients with stage III hepatocellular carcinoma [J]. Am J Clin Oncol, 2003, 26(4):e92-e99.
- 11. 鄧瑜萍, 楊志剛, 謝建國,等. 原發(fā)性肝癌介入治療并發(fā)癥原因分析和對策[J]. 華西醫(yī)學(xué), 2006, 21(2):298-299.
- 12. KIM T H, KIM D Y, PARK J W, et al. Dosevolumetric parameters predicting radiationinduced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with threedimensional conformal radiotherapy [J]. Int J Radiat Oncol Biol Phys, 2007, 67(1):225-231.