调强适形放疗联合热疗治疗介入后原发性肝癌的临床疗效

目的观察调强适形放疗联合热疗治疗介入后原发性肝癌的临床疗效,并探讨放疗剂量及毒副反应。方法 2009年3月至2011年8月收治的44例原发性肝癌患者,所有患者均已行2～4周期介入治疗,介入治疗后采用非随机对照研究的方法,按患者意愿分为2组,2组年龄、性别、卡氏评分、Childpugh分级、肿瘤直径、介入周数比较,差异均无统计学意义(P均>0.05)。放疗组20例患者采取单纯调强适形放疗;联合组24例患者采取调强适形放疗联合深部聚焦热疗,每次均于放疗结束后2h内进行。结果联合组肿瘤消退有效率(CR+PR)79.2%(19/24),其中CR33.3%(8/24),PR45.8%(11/24);放疗组肿瘤消退有效率50.0%(10/20),其中CR20.0%(4/20),PR30.0%(6/20)。联合组有效率高于放疗组,差异有统计学意义(P<0.05)。各种治疗毒副反应发生率2组比较差异无统计学意义。结论调强适形放疗联合热疗较单纯放疗可显著提高介入后原发性肝癌的局部有效率,是治疗原发性肝癌的有效手段,且不增加毒副反应。

The clinical effect of radiotherapy combined with hyperthermia in the treatment of primary hepatocellular carcinoma after interventional therapy

Objective To observe the efficacy of intensity modulated radiation therapy(IMRT) combined with hyperthermia for treating primary hepatocellular carcinoma following interventional therapy and explore the radiotherapeutic dose and the toxic-side reactions.Methods Forty-four patients with primary hepatocellular carcinoma treated by interventional therapy for 2-4 cycles were allocated into the radiotherapy group(n=20) and the combined therapy group(n=24) according to the wishes of patients.IMRT alone was adopted in the radiotherapy group,and IMRT combined with hyperthermia with deep focus technology was performed within 2 hours following radiotherapy in the combined therapy group.Results The effective rate in combined therapy group was 79.2%(CR 33.3%,PR 45.8%),and 50.0% in radiotherapy group(CR 20.0%,PR 30.0%),there was significant difference between two groups(P<0.05).There was no significant difference in the incidence of toxic-side reactions between the two groups(P>0.05).Conclusions Compared with radiotherapy alone,IMRT combined with hyperthermia can significantly elevate the local effective rate of primary hepatocellular carcinoma following interventional therapy,and the toxic-side reactions have no increase.