介入治疗联合三维适形或调强放疗治疗中晚期肝癌

目的:探讨介入治疗联合3-DCRT或IMRT治疗中晚期肝癌的临床疗效和安全性。方法:选取2012年2月-2014年2月在我院肿瘤科住院治疗的126例中晚期肝癌患者为研究对象。运用随机数字表法将符合本研究纳入标准和排除标准的患者分为两组，A组和B组，每组63例。A组患者仅给予经导管肝动脉化疗栓塞治疗，而B组患者则先经导管肝动脉化疗栓塞(TACE)治疗后再进行三维适形放疗(3-DCRT)或调强放疗(IMRT)。比较A组和B组患者近期疗效和药物毒副反应发生情况。结果:B组患者治疗总有效率77.78%，明显高于A组患者治疗总有效率的55.56%，差异有统计学意义(P<0.05)。A组治疗后的血液白血球下降、易疲劳、消化系统反应多于B组(P<0.05)，而骨髓抑制和急性肝功能损伤与B组差异没有统计学意义（P>0.05）。结论:介入治疗联合3-DCRT或IMRT治疗中晚期肝癌临床疗效确切，安全高效，毒副反应少，值得进一步推广。

Clinical observation of patients with advanced hepatocellular carcinoma treated by inter-ventional therapy combined with 3 -DCRT or IMRT

Objective:To investigate the clinical efficacy and safety of interventional treatment combined with 3 -DCRT and IMRT treatment on advanced liver cancer.Methods:All 126 patients with advanced liver cancer patients were divided into two groups,group A and group B with 63 cases in each.In group A patients only received transcath-eter hepatic arterial chemoembolization therapy,while patients in group B firstly received transcatheter hepatic arterial chemoembolization (TACE)therapy,then three -dimensional conformal radiotherapy (3 -DCRT)and intensity -modulated radiotherapy (IMRT).Results:In group B total efficiency was 77.78%,which was significantly higher than that of patients in group A(55.56%),and the difference was statistically significant (P <0.05).The differ-ences of blood leucocyte decline,loss of appetite,fatigue were significant between group A and group B,while the differences of bone marrow suppression and acute liver injury were not significant (P >0.05).Conclusion:Interven-tional therapy combined with 3 -DCRT and IMRT treatment of advanced liver cancer is safe and effective.