立体定向适形放射治疗（光子刀）综合肝动脉栓塞化疗治疗中晚期原发性肝癌疗效观察

目的　探讨立体定向适形放疗 (SCRT)加肝动脉栓塞化疗 (TACE)对中晚期原发性肝癌的治疗效果。方法　将 1 0 4例中晚期原发性肝癌随机分为两组 ,TACE SCRT(综合组 ) ,和单纯 TACE(对照组 )各 5 2例 ,综合组先予羟基喜树碱、5 -Fu、DDP和超液化碘油行 TACE,2周后行 SCRT,使用 8mvx线 ,4～ 8Gy/f,共照 8～ 1 5次 ,隔日照射 ,使90 %等剂量线包完 90 %的肝癌体积 ;对照组 1、3、6月各行 TACE1次 ,共治疗 3次。结果　综合组近期疗效 (CR PR)为88.6% ,对照组为 5 7.6% ,综合组与对照组有显著性差异 (P <0 .0 1 )。综合组、对照组的 1 2、1 8和 2 4个月生存率分别为71 .1 %、5 5 .8%和 3 8.5 % ,5 0 .0 %、2 5 .0 %和 1 9.2 % ,综合组明显优于对照组 (P <0 .0 1 )。两组副反应无显著性差异 (P>0 .0 5 ) ,病人能耐受。结论　TACE SCRT治疗中晚期原发性肝癌是安全有效的方法之一

Therapeutic effects of transcatheter arterial chemoemboliztation of stereotactic conformal radiotherapy for the mid-and-late primary hepatic cacinoma

Objective To evaluate the therapeutic effects of stereotactic conformal radiotherapy (SCRT) plus transeatheter arterial chemoemboliztina (TACE) on mid and late primary hepatic cinoma (PHC).Methods One hundred and four patients with PHC were divided into two groups:Fifty two were treated with TACE SCRT and another fifty two were treated with TACE alone.For TACE SCRT,HCPT,5 Fu,DDP and iodized oil were first given to TACE and then after two weeks,the TACE were followed by SCRT with 8mv X ray,4~8 Gy/f,per session every other day,8~15 times altogether in order to cover 90% volume of tumor with 90% Gy.For TACE,the pateints were given TACE in one month,three months and six months with three times altogether.Results The response rate(CR PR) of TACE SCRT group and TACE alone group were 88 6% and 57 6%,with significant difference(p<0 01).The 12-,18-,24-month survival rates of TACE SCRT group and TACE group alone were 71 1%,55 8%,38 5% and 50 0%,25 0%,19 2%.TACE SCRT group is clearly superior to SCRT group(P<0 01).There is no difference of side response of the two groups(P>0 05) and the patients can bear it.Conclusions TACE SCRT is a safe and effective method for treating the mid and late primory hepatic carcinoma.