介入治疗结合分次立体定向适形放疗交替治疗肝癌的疗效评价

目的:比较肝动脉化疗栓塞(TACE)与联合分次立体定向适形放疗(FSCR)交替治疗原发性肝癌的疗效.方法:90例PHC患者随机分成单纯介入组与介入加放疗组(综合组).综合治疗组采用TACE结合FSCR,观察近期疗效与生存率,并用COX比例风险模型分析预后因素.结果:综合治疗组和对照组1、3、5年生存率分别为91.1%、62.2%、24.4%和73.3%、37.8%、8.9%,两组生存率比较差异有显著性(P＜0.05).结论:放疗对病灶周边门静脉供血为主的肿瘤病灶的杀灭,是本疗法比单纯介入治疗(TACE)疗效增高的关键.综合治疗组中肿瘤直径、肿瘤数目、Child分级、Okuda分期为影响预后的最主要因素.

Evaluation of the Efficacy for Alternated Treatment on Primary Liver Cancer by Interventional Therapy in Combination with Fractionated Stereotactic Conformal Radiotherapy

Objective: To compare effect of the therapeutic hepatic chemoembolization(TACE) alone with that of TACE combined fractionated stereotactic conformal radiation therapy(FSCR) with scheme alternated for primary hepatic cancer were randomly divided into TACE alone group and TACE combined with FSCR group.Acute effects and survival rates were observed.The cox proportional hazards model was used to analyze the prognostic factors.Results: The overall survival rates in group A(91.1%,62.2% and 24.4% at 1,3 and 5 years,respectively) were significantly higher than that in group B(73.3%,37.8% and 8.9%,respectively,P<0.05).Conclusions: Radiotherapy plays an important role for increasing the therapeutic effect by killing off the cancer cells in border area with portacaval perfusion,compared to the treatment with TACE alone.In group A,the number and diameter of the tumor,child-pugh classification and okdua staging are the key factors in clinical prognosis.