肝动脉化疗栓塞联合三维适形放疗治疗肝癌合并门脉癌栓的临床对照研究

目的研究肝动脉化疗栓塞（TACE）联合三维适形放疗（3DCRT）治疗肝癌合并门脉癌栓（PVTT）的疗效。方法138例肝癌患者随机分为2组：A组（62例）单纯行TACE；B组（76例）行TACE结合3DCRT。大体肿瘤靶区（GTV）只包括癌栓，不包括原发灶，使90％等剂量曲线覆盖PTV，照射总量40～65Gy，单次照射剂量2～4Gy。结果A组1、2年生存率分别为20．3％、3．9％，平均生存期7．2个月，有效率（CR＋PR）为16．1％（10／62）；B组1、2年生存率分别为40．6％、22．3％，平均生存期15．5个月，总有效率为42．11％（32／76），P〈0．05。结论TACE联合3DCRT能明显提高合并门脉癌栓的肝癌的治疗效果。

Clinical control study on combined three-dimensional conformal radiotherapy and transcatheter arterial chemoembolization for portal vein tumor thrombus in patients with hepatocelular carcinoma

Objectives To investigate clinical therapeutic effect of combined three-dimensional conformal radiothempy (3DCRT) and transcatheter arterial chemoembolization (TACE) for portal vein tumor thrombus (PVTT) in hepatocellular carcinoma (HCC).Methods One hundred and thirty eight HCC patients with tumor thrombus in the portal vein were divided into two groups randomly .Group A(62 cases)was treated with TACE only while group B(76cases)with 3DCRT combined TACE . The gross tumor volume(GTV) was defined as only PVTT. Results Survival rates of group A at year 1 and 2 were 20.3% and 3.9% respectirely with the mean survival time(MST) of 7.2 months, while those of group B were 40.6% and 22.3% with MST of 15.5 months. The total effective rates of group A and B were 17.74%(11/62) and 42.11% (32/76)respectively.Conclusions 3DCRT combined with TACE can elevate the therapeutic effect of portal vein tumor thrombus in hepatocellular carcinoma.