TACE联合X-刀FSRT治疗中晚期原发性肝癌疗效观察

目的评价TACE（肝动脉栓塞化疗）联合X-刀FSRT（X-刀立体定向分次放射治疗）对原发性肝癌（PHC）的疗效。方法57例确诊的原发性肝癌患者分为两组,均先行TACE 1-4次,26例加用FSRT治疗,FSRT分次量3-4 Gy,3次/周,治疗剂量40-60 Gy。结果治疗后复查,TACE＋FSRT组和TACE组两组局部控制率（CR＋PR）分别为80.8%和51.6%,P〈0.05。1,2,3年生存率分别为67.8%、29.0%、0和76.9%、53.9%、0,2年生存率比较差异有显著性（P〈0.05）;放疗反应及并发症未见明显增加。结论TACE联合X-刀FSRT治疗中晚期原发性肝癌疗效好,毒副反应轻,但应严格掌握其治疗适应证。

Efficacy of transcatheter arterial chemoembolization combined with X-knife under fractionated stereotactic radiotherapy in treatment of primary hepatic carcinoma

Objective To evaluate efficacy of transcatheter arterial chemoembolization（TACE） combined with X-knife under fractionated stereotactic radiotherapy（FSRT） in treatment of primary hepatic carcinoma（PHC）.Mehods Fifty-seven patients with PHC were divided into two groups randomly.All patients were given TACE for 1 to 4 times,then the TACE＋FSRT group（26 patients） were given X-knife under FSRT.The fraction dose of FSRT was 3 to 4 Gy,3 times once a week, the total dose was 40 to 60 Gy. Result After the treatment, all patients were evaluated for the efficacy by CT or MR scanning. In the TACE ＋ FSRT group, the CR ＋ PR was 80. 8%, but in the TACE group, it was 51.6%, with significant difference between the two groups, P 〈0. 05. The 1-,2-,3-year survival rates were 67.8% ,29. 0% ,0 and 76. 9% ,53.9% ,0, there was significant difference in 2-year survival rates between the two groups , P 〈 0. 05. As for the side effects and the complications, there was no difference between the two groups. Condusion The results of TACE combined with X-knife under fractionated stereotactic radiotherapy （FSRT） for treatment of PHC were encouraging with mild toxicity.