TACE联合3DCRT治疗肝癌伴门静脉癌栓疗效分析

目的：分析肝动脉化疗栓塞（TACE）结合三维适形放射治疗对原发性肝癌（HCC）并门静脉癌栓（PVVT）的疗效。方法：2004年10月至2009年10月,共收治32例HCC合并PVVT患者,采用肝动脉化疗栓塞联合三维适形放射治疗,观察肿瘤及癌栓的近期疗效,用Kaplan-Meier法进行生存分析,采用Cox比例风险模型作多因素分析。结果：原发灶肿瘤近期有效率71.9%,癌栓有效率为81.3%。平均生存时间为20.63±1.23个月,中位生存时间为19.0±1.02个月。多因素分析显示肿瘤分期、癌栓类型、肝功Child-Pugh分级、卡氏评分是影响预后的主要因素（P〈0.05）。结论：TACE联合3DCRT治疗肝癌合并PVTT疗效好,损伤小,易耐受,是治疗HCC合并PVTT有效治疗方法。

Transcatheter arterial chemoembilization combined with three-dimensional conformal radiotherapy for hepatocellular carcinoma with portal vein tumor thrombus

Objective：To evaluate the efficacy and safety of transcatheter arterial chemoembolization（TACE） combined with three-dimensional conformal radiotherapy（3DCRT） in the treatment for primary hepatocellular carcinoma with portal vein tumor thrombus（PVTT）.Methods： From 2004 to 2009,32 patients with PVTT of hepatocellular carcinoma were treated with TACE combined with 3DCRT in our department.The objective responses were analyzed and the survival rates were assessed from the date of the begining of treatment using Kaplan-Meier method.Results： The overall response rate of HCC was 71.9%.The remission rate of PVTT was 81.3%.The mean survival time was 20.63 ±1.23 months,the median survival time was 19.0±1.02 months.Multivariate analysis revealed the phase of tumor,type of PVTT,Child-Pugh class,Karnofsky grade were independent prognostic factors for the survival probability of patients（P〈0.05）.Conclusion： TACE combined with 3DCRT is an effective,feasible approach in the treatment of portal vein tumor thrombus in hepatocellular carcinoma.