高强度聚焦超声与三维适形放疗治疗门静脉癌栓的对比研究

目的 对比分析肝动脉栓塞化疗（TACE）联合高强度聚焦超声（HIFU）与肝动脉栓塞化疗联合三维适形放疗（3-DCRT）治疗门静脉癌栓（PVTT）的疗效和不良反应。方法 回顾性分析我院65例原发性肝细胞肝癌（HCC）合并PVVT患者的治疗情况，TACE联合HIFU治疗34例（A组）、TACE联合3-DCRT治疗31例（B组） 。结果 A组的近期有效率为70.59% （24/34），B组的近期有效率为67.74%（21/31），两组比较差异无统计学意义（P=0.804）。A组6月、1、2年的生存率为91.12%（31/34）、61.76%（21/34）、20.59%（7/34），B组6月、1、2年的生存率为87.10%（27/31）、64.52%（20/31）；16.13%（5/31）；A组病例的生存期为3.8～25.6月，中位生存期13.4月，B组病例生存期4.3～24.8月，中位生存期为12.6月，两组比较差异无统计学意义（P=0.167），但B组不良反应发生率明显高于A组。结论 TACE治疗基础上，HIFU与3-DCRT治疗PVTT均具有较好的疗效，HIFU治疗的不良反应明显低于3-DCRT。

High-intensity Focused Ultrasound Compared with Three-dimensional Conformal#br# Radiotherapy in Treatment for Portal Vein Tumor Thrombosis

Objective To compare the efficacy and adverse effects of transcatheter hepatic arterial chemoembolization(TACE) combined with high intensity focused ultrasound(HIFU) and TACE combined withthree-dimensional conformal radiotherapy(3-DCRT) on patients with portal vein tumor thrombosis (PVTT).Methods Data of hospitalized 65 patients with hepatocellular carcinoma(HCC) combined with PVTTwere retrospectively analyzed. They were divided into two groups randomly, Group A, 34 cases receivedTACE combined with HIFU, and Group B, 31 cases received TACE combined with 3-DCRT. Response rate,overall survival and adverse effects were evaluated between two groups. Results The total response ratewas 70.59%(24/34) in Group A and 67.74%(21/31) in Group B, with no significant difference (P=0.804).The overall survival rates at 0.5, 1 and 2 years were 91.12%(31/34), 61.76%(21/34) and 20.59%(7/34) inGroup A, and 87.10%(27/31), 64.52%(20/31) and 16.13%(5/31) in Group B. The median survival time were13.4 months (range: 3.8-25.6) in Group A and 12.6 months (range: 4.3-24.8) in Group B, with no significantdifference(P=0.167). The occurance rates of adverse effects in Group B were much higher than those in GroupA. Conclusion TACE combined with HIFU and 3-DCRT separately are both safe and effective approachesin the treatment of PVTT patients, while HIFU was superior to 3-DCRT on adverse effects.