TACE联合三维适形放疗治疗肝癌合并门静脉癌栓的疗效观察

目的探讨肝动脉化疗栓塞术(TACE)联合三维适形放疗技术(3DCRT)治疗原发性肝癌(PHC)合并门静脉癌栓(PVTT)的临床疗效和安全性。方法 60例经病理组织学确诊的PHC伴PVTT患者分为治疗组和对照组。治疗组采用TACE联合3DCRT治疗,对照组单纯采用TACE治疗。疗程结束后评价近期疗效、观察不良反应,随访1年评价客观疗效和生存率。结果治疗组近期疗效有效率为80.0%,高于对照组(43.3%),相比较差异有统计学意义,P<0.05;治疗组患者随访期内有18例死亡,对照组患者随访期内有24例死亡,治疗组中位疾病进展时间、1年生存率显著高于对照组,相比较差异有统计学意义,P<0.05。两组患者对毒性反应均可耐受。结论 TACE联合3DCRT治疗PHC合并PVTT患者临床疗效肯定,不良反应小,值得临床推广应用。

Clinical investigation on the efficacy of TACE combined with three-dimensional conformal radiotherapy for hepatocellular carcinoma with portal vein tumor thrombus

Objective To evaluate the clinical efficacy and safety of hepatic arterial chemoembolization(TACE) combined with three-dimensional conformal radiotherapy(3DCRT) treatment on hepatocellular carcinoma(PHC) patients with and portal vein tumor thrombus(PVTT).Methods 60 cases of histologically confirmed patients were divided into two groups: treatment and control groups.The treatment group were treated with TACE combined with 3DCRT treatment,control group were treated with TACE treatment only.After treatment,the short-term effect and toxicity were evaluated,and the long-term effect and survival rate were determined after 1-year follow-up.Results the effective rate of short-term effect of the treatment group(80.0%) was higher than that of the control group(43.3%),statistical results suggested the difference reached statistical significance,P<0.05.During the follow-up period,18 cases from the treatment group while 24 patients from the control group died.The median time of disease progression and 1-year survival rate in treatment group were significantly higher than control group,P<0.05.The two groups all exibited tolerance to toxicity.Conclusion With the advantage of better effect,smaller toxicity,the strategy of TACE combined with the 3DCRT on PHC patients with PVTT worth clinical application.