三维适形放射治疗门静脉癌栓疗效分析

目的 探讨三维适形放射治疗门脉癌栓的临床疗效.方法 95例肝癌介入治疗1～4次后出现门静脉癌栓.采用三维适形照射的方法 ,设3～6个非共面野,单次照射剂量2～7 Gy,6～30次,每日或隔日照射,总剂量42～60 Gy.结果 总有效率3个月为83.2%,6个月为91.6%;1、2、3年生存率分别为79.5%、51.9%和29.7%,中位生存期17个月.Cox回归分析显示Child-Pugh肝功能分级与预后有关.结论 三维适形放射治疗门静脉癌栓是一种方法 简单、病人易于接受、近期疗效显著的可行方法 ,值得临床推广.

Three-dimensional conformal radiotherapy for portal venous cancer embolus in 95 cases

Objective To study the recent clinical efficacy of three-dimensional conformal radio-therapy (3DCRT) for portal venous cancer embolus (PVCE). Methods A total of 95 patients had PVCE after transcatheter arterial chemoembolization (TACE). Fifty-eight patients were with primary hepatic carcinoma and 37 with transferring hepatic cancer. The PVCE was appeared in all the patients after TACE for 1-4 times. Using 3DCRT to treat all of patients, the radiation was performed by using 3-6 non-coplanar stationary beams, single dose for 3DCRT was 2-7Gy, each or once every 2 days, in 6-30 fractions and at a total dose of 42-60Gy. Results The total effective rate (CR+PR) was 83.2% in 3 months and 91.6% in 6 months. Kaplan-Merie analysis revealed that 1-, 2- and 3-year survival rates were 79.5%, 51.9% and 29.7%, respectively. The median survival time 17 months. The Clild-pugh class was an independent prognostic factor when being analyzed by Cox proportional hazards model. Conclusion The 3DCRT is a simple and effective method to treat PVCE after TACE in pa-tients with hepatic carcinoma in shorter time. Thus it should be recommended to be used in clinical practice.