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1、原发性肝癌介入治疗适形放射治疗及综合治疗的前瞻性研究中国临床实用医学2010年9月第4卷第9期ChinaClinPracMed,Sep2010*01..原发性肝癌介入治疗适形放射治疗及综合治疗的前瞻性研究卢渊泉【摘要】目的比较单纯介入肝动脉化疗栓塞（TACE）,单纯适形放射治疗（3DCRT）,TACE+3DCRT对原发性肝癌（PHC）的疗效方法67例PHC患者随机分为3个组,A组25例（TACE1—5次，平均3.2次）,B组20例（3DCRT45〜60Gy,平均5OGy）,C组22例（TACE+3DCRT,先行
2、TACE1-4次，平均3次，休息4〜8周后3DCRT;TACE和3DCRT方法与A,B组相同）•介入化疗先将氟月尿卩密旋10001250mg和拜基树碱20~30mg后将顺钳60~80mg和丝裂霉素14~20mg（或阿霉素50一60mg）与超液化碘油10—30mg充分混合成乳剂缓慢注入，再用l-2mm明胶海绵颗粒栓塞肝动脉•适形放疗采用6MV-X直线加速器治疗•结果1,2,3年生存率A组分别为61.3%,34.0%,19.8%;B组分别为53」%,31.3%,18.8%;C组分别为74.8%,57.0%,40.4
3、%.C组>A组和B组（Logrank检验,PABC,PAC,PBC<0.05,PAB>0.05）发症主要为发热,c组>A组>B组（检验,P<0.01）;白细胞下降,C组>A组>B组（t检验和方差分析,P<0.01）;肝功能不全,C组>B组>A组（检验,P<0・01）・结论PHC疗效TACE+3DCRT优于单纯TACE和3DCRT,TACE与3DCRT相近.并发症主要是发热，白细胞下降(TACE+3DCRT>TACE>3DCRT)
4、和肝功能不全(TACE+3DCRT>3DCRT>TACE).［关键词】肝肿瘤/治疗;肝肿瘤/放射疗法;栓塞,治疗性ForesightednessresearchofthreedimensionalconformalradiotherapyandcomplextherapyforprimaryhepaticcancerLUYuan一quan.Tumorradiotherapydepartment.TheFirstpeopleHsHospitalofShangQiuHeifl-a476100,China
5、【Abstract】ObjectiveTocomparethetherapeuticeffectsoftranscatheterhepaticchemoembolization(TACE)alone,threedimensionalconformalradiotherapy(3DCRT)alone,andTACE+3DCRT.Methods67patientswithprimaryhepaticcacerwererandomizeddividedintothreegroups:A-25patientsweret
6、reatedwith1一5timesofTACEalone;B-20patients,radiotherapywith3DCRT45-60Gyaverage50Gy;Groupc-22patients,TACEplusradiotherapy,atthefirsttimewerereceivedl-4timesofTACEbyradiotherapy,thenwith3DCRTaf-terarestof4-8week.forTACE,1000一1250mg5-fluorouraciland20一30mghydr
7、oxyeamptothecinewereper-fusedintothehepaticarteries4hen60・80mgcisplatinand14・20mgmitomycin(or50・60mgepirubicin)andio一dizedoillO一30mlweregiventoembolizedthehepatica-erieswhichwasthenfollowedby1-2millgelfdrmspieces.For3DCRT,radiationwas百venby6MVX一ray.ResultsTh
8、eoverallsurvivalsatl~,2-and3-yearswere61.3%,34.0%and19.O%forA—groupTACEalone,53.1%,31.3%and18.8%forB-group3DCRT;74.8%,57.0%and40.4%forC?groupTACE+3DCRT.Thedifferencesinthesurvivalsarestatistical
