口服希罗达联合TACE、3D-CRT治疗原发性肝癌合并门静脉癌栓的临床研究

目的探讨不能手术伴有门静脉癌栓(PVTT)的原发性肝癌(PHC)安全而疗效较好的治疗方法,为制定合理的治疗措施提供临床依据。方法 2005年3月~2008年4月期间在本院住院的原发性肝癌合并门静脉癌栓患者共38例,采用肝动脉栓塞化疗(TACE)1~2次后,再以三维适形放疗(3D-CRT)技术给予残留病灶及门静脉癌栓放疗,3~6 Gy/次,每周3次,DT40~55 Gy;放疗期间同步口服希罗达化疗,每3周1个疗程,共1~2个疗程。结果原发灶肿瘤近期有效率69.7%,1年生存率72.7%,2年生存率57.6%。多因素分析显示肿瘤分期、肝功能Child-Pugh分级、卡氏评分是影响预后的主要因素(P<0.05)。结论口服希罗达联合TACE、3D-CRT治疗原发性肝癌合并门静脉癌栓具有疗效好,损伤小且易耐受,是治疗原发性肝癌并门静脉癌栓有效的治疗方法。

Clinical study of capecitabine combined with TACE and 3D-CRT in treatment for portalvein tumor thrombus in patients with hepatocellular carcinoma

Objective To explore the safe and effective treatment for inoperable primary hepatic carcinoma(PHC) with portal vein tumor thrombus(PVTT),to provide the clinical basis for the development a reasonable treatment measure.Methods Analyze the clinical data of 38 cases of PVTT From March 2005 to April 2008.The patients were treated with transcatheter arterial chemoembolization(TACE) followed by three-dimensional conformal radiotherapy(3-DCRT) combined with oral xeloda.Results Primary tumors′s hort-term effectire rate(CR+PR) was 69.7%;The 1-2-year survival rate was 72.7,57.6%.Cox proportional hazards model analysis showed the phase of tumor,Child-Pugh class,Karnofsky grade were the independent prognostic factor for the survival probability of the patients(P<0.05).Conclusions With less damage and less toxicity,capecitabine combined with TACE and 3D-CRT is an effective method in the treatment of portal vein tumor thrombus in hepatocellular carcinoma.