大分割调强放射治疗对中晚期肝癌的近期疗效分析

目的探讨大分割调强放射治疗对中晚期肝癌患者的近期疗效及毒副反应。方法选取2012年11月~2013年8月在我院住院的36例经临床确诊的中晚期肝癌患者,根据治疗方法不同分为大分割调强放射治疗组和三维适形放射治疗组,各18例。大分割调强放射治疗组采用调强大分割放疗,分割剂量2.5~3.5GY,1次/d,5次/周,95%剂量曲线包绕计划靶体积PTV,总剂量35~45GY。三维适形放疗组采用三维适形放疗,肿瘤剂量2Gy/次,1次/d,5次/周,总剂量40~50Gy。观察比较两组患者的近期疗效和毒副反应。结果治疗2个月后,大分割调强放射治疗组总有效率为77.8%,三维适形放疗组总有效率为66.7%,两组总有效率比较,差异有统计学意义(P<0.05)。两组患者毒副反应相似,无统计学意义(P>0.05)。结论大分割调强放射治疗中晚期肝癌可以有效地提高肿瘤的局部控制率,毒副反应患者可以耐受,提高了近期疗效。

Analysis on short-term efficacy of hypofractionated intensity-modulated radiation therapy in the treatment of advanced hepatocellular carcinoma

Objective To discuss the short-term efficacy and side effects of hypofractionated intensity-modulated radiation therapy in the treatment of patients with advanced hepatocellular carcinoma. Methods A total of 36 inpatients with advanced hepatocellular carcinoma confirmed in our hospital from November 2012 to August 2013 were selected, and divided into the hypofractionated intensity-modulated radiation therapy group and three-dimensional conformal radiotherapy group according to the different treatment methods, 18 cases in each. The hypofractionated intensity-modulated radiation therapy group were treated by hypofractionated intensity-modulated radiation therapy, divided doses of 2.5 - 3.5 GY, 1 times/d, and 5 times per week, 95% wrapped around the planning target volume PTV dose curve, total dose of 35-45 GY. The three-dimensional conformal radiotherapy group were treated by three-dimensional conformal radiotherapy, tumor doses of 2GY each times, 1 times/d, and 5 times per week, total dose of 40-50 GY. The short-term efficacy and side effects of patients in the two groups were observed and compared. Results After 2 months of treatment, the total effective rate of the hypofractionated intensity-modulated radiation therapy group was 77.8%, while that of the three-dimensional conformal radiotherapy group was 66.7%, the difference was significant between the two groups（P〈0.05）. The side effects of patients in the two groups were similar, and the difference was not significant（P〉 0.05）. Conclusion Hypofractionated intensity-modulated radiation therapy in the treatment of advanced hepatocellular carcinoma can effectively improve the tumor local control rate and the patients with adverse reactions can be tolerated. Hypofraetionated intensity-modulated radiation therapy increases the short-term efficacy.