CAJ | 학술논문

目的观察三维适形放疗(3DCRT)联合肝动脉化疗栓塞(TACE)治疗肝癌合并门脉癌栓(PVTT)的疗效.方法经过CT/MRI证实伴有门静脉癌栓的肝癌患者共145例,其中单纯手术64例(A组),接受TACE结合3DCRT治疗共81例(B组):大体肿瘤靶区(GTV)只包括癌栓,不包括原发灶,使90％等剂量曲线覆盖计划靶体积(PTV),照射总量45～60 cGy,单次照射剂量2 ～4 Gy.结果 A组1、2年生存率分别为40.3％、21.9％,平均生存期15.2个月,有效率[完全缓解(CR)+部分缓解(PR)]为40.6％(28/64)；B组1、2年生存率分别为41.2％、22.5％,平均生存期15.8个月,总有效率为44.4％(36/81),P＞0.05.结论 TACE联合3DCRT与手术治疗肝细胞癌合并门脉癌栓的肝癌的疗效相近.
목적 관찰삼유괄형방료(3DCRT)연합간동맥화료전새(TACE)치료간암합병문맥암전(PVTT)적료효.방법 경과CT/MRI증실반유문정맥암전적간암환자공145례,기중단순수술64례(A조),접수TACE결합3DCRT치료공81례(B조):대체종류파구(GTV)지포괄암전,불포괄원발조,사90％등제량곡선복개계화파체적(PTV),조사총량45～60 cGy,단차조사제량2 ～4 Gy.결과 A조1、2년생존솔분별위40.3％、21.9％,평균생존기15.2개월,유효솔[완전완해(CR)+부분완해(PR)]위40.6％(28/64)；B조1、2년생존솔분별위41.2％、22.5％,평균생존기15.8개월,총유효솔위44.4％(36/81),P＞0.05.결론 TACE연합3DCRT여수술치료간세포암합병문맥암전적간암적료효상근.
Objective To explore the clinical therapeutic efficacies of combined three-dimensional conformal radiotherapy(3DCRT)plus transcatheter arterial chemoembolization(TACE)for portal vein tumor thrombus(PVTT)in hepatocellular carcinoma(HCC).Methods A total of 145 HCC patients with tumor thrombus in portal vein were divided randomly into 2 groups.Group A(n =64)was treated with surgical intervention alone while group B(n =81)underwent 3DCRT plus TACE.The gross tumor volume (GTV)was defined as PVTT only.Results Survival rates of group A at year 1 and 2 were 40.3％ and 21.9％ with a mean survival time(MST)of 15.2 months while that of group B were 41.2％ and 22.5％with a MST of 15.8 months.The total effective rates of groups A and B was 40.6％(28/64)and 44.4％ (36/81)respectively.Conclusion The therapeutic efficacy of 3DCRT plus TACE is similar to that of surgical intervention.