中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
17期
11-14
,共4页
高宗毅%张继宝%刘江涛%刘永利
高宗毅%張繼寶%劉江濤%劉永利
고종의%장계보%류강도%류영리
肝肿瘤%化学栓塞,治疗性%甲胎蛋白类%三维适形放疗
肝腫瘤%化學栓塞,治療性%甲胎蛋白類%三維適形放療
간종류%화학전새,치료성%갑태단백류%삼유괄형방료
Liver neoplasms%Chemoembolization,therapeutic%Alpha-fetoproteins%Three-dimensional conformal radiotherapy
目的 探讨大分割三维适形放疗(3DCRT)联合经导管动脉化疗栓塞(TACE)治疗不能手术原发性肝癌的临床疗效.方法 102例不能手术切除的中晚期原发性肝癌患者按随机数字表法分为两组,对照组49例,采用TACE治疗,观察组53例,采用大分割3DCRT联合TACE治疗,定期检查,判断两组患者近期疗效,调查患者1、2、3年生存率、不良反应以及治疗后血清甲胎蛋白(AFP)的表达情况.结果 观察组患者完全缓解率、进展率、总有效率分别为17.0％ (9/53)、11.3％(6/53)、73.6％ (39/53),对照组分别为2.0％(1/49)、28.6％(14/49)、51.0％( 25/49),两组比较差异有统计学意义(P＜0.05).两组不良反应比较差异无统计学意义(P＞0.05).对照组1、2、3年的生存率分别为51.0％(25/49)、28.6％( 14/49)、14.3％ (7/49),中位生存期为15个月；观察组分别为71.7％(38/53)、52.8％( 28/53)、39.6％( 21/53)、20个月.观察组2、3年生存率明显高于对照组,差异有统计学意义(P＜ 0.05或＜0.01).观察组血清AFP阳性患者治疗前后无明显变化率为9.8％(4/41),与对照组的31.6％( 12/38)比较差异有统计学意义(P＜0.05).结论 大分割3DCRT联合TACE治疗不能手术原发性肝癌的临床疗效好,值得在临床中推广.
目的 探討大分割三維適形放療(3DCRT)聯閤經導管動脈化療栓塞(TACE)治療不能手術原髮性肝癌的臨床療效.方法 102例不能手術切除的中晚期原髮性肝癌患者按隨機數字錶法分為兩組,對照組49例,採用TACE治療,觀察組53例,採用大分割3DCRT聯閤TACE治療,定期檢查,判斷兩組患者近期療效,調查患者1、2、3年生存率、不良反應以及治療後血清甲胎蛋白(AFP)的錶達情況.結果 觀察組患者完全緩解率、進展率、總有效率分彆為17.0％ (9/53)、11.3％(6/53)、73.6％ (39/53),對照組分彆為2.0％(1/49)、28.6％(14/49)、51.0％( 25/49),兩組比較差異有統計學意義(P＜0.05).兩組不良反應比較差異無統計學意義(P＞0.05).對照組1、2、3年的生存率分彆為51.0％(25/49)、28.6％( 14/49)、14.3％ (7/49),中位生存期為15箇月；觀察組分彆為71.7％(38/53)、52.8％( 28/53)、39.6％( 21/53)、20箇月.觀察組2、3年生存率明顯高于對照組,差異有統計學意義(P＜ 0.05或＜0.01).觀察組血清AFP暘性患者治療前後無明顯變化率為9.8％(4/41),與對照組的31.6％( 12/38)比較差異有統計學意義(P＜0.05).結論 大分割3DCRT聯閤TACE治療不能手術原髮性肝癌的臨床療效好,值得在臨床中推廣.
목적 탐토대분할삼유괄형방료(3DCRT)연합경도관동맥화료전새(TACE)치료불능수술원발성간암적림상료효.방법 102례불능수술절제적중만기원발성간암환자안수궤수자표법분위량조,대조조49례,채용TACE치료,관찰조53례,채용대분할3DCRT연합TACE치료,정기검사,판단량조환자근기료효,조사환자1、2、3년생존솔、불량반응이급치료후혈청갑태단백(AFP)적표체정황.결과 관찰조환자완전완해솔、진전솔、총유효솔분별위17.0％ (9/53)、11.3％(6/53)、73.6％ (39/53),대조조분별위2.0％(1/49)、28.6％(14/49)、51.0％( 25/49),량조비교차이유통계학의의(P＜0.05).량조불량반응비교차이무통계학의의(P＞0.05).대조조1、2、3년적생존솔분별위51.0％(25/49)、28.6％( 14/49)、14.3％ (7/49),중위생존기위15개월；관찰조분별위71.7％(38/53)、52.8％( 28/53)、39.6％( 21/53)、20개월.관찰조2、3년생존솔명현고우대조조,차이유통계학의의(P＜ 0.05혹＜0.01).관찰조혈청AFP양성환자치료전후무명현변화솔위9.8％(4/41),여대조조적31.6％( 12/38)비교차이유통계학의의(P＜0.05).결론 대분할3DCRT연합TACE치료불능수술원발성간암적림상료효호,치득재림상중추엄.
Objective To investigate the clinical effect of hyper-fractionated three-dimensional conformal radiotherapy (3DCRT) combined with transcatheter arterial chemeembolization (TACE) for heating patients with inoperable primary liver cancer.Methods One hundred and two patients with inoperable advanced primary liver cancer were divided by random digits table method into control group with 49 cases treated with TACE and observation group with 53 cases treated with hyper-fractionated 3DCRT combined with TACE.The short-term efficacy,adverse reaction and survival rate of the 1st,2nd and 3rd year and serum alpha-fetoprotein (AFP) expression after treatment in two groups were observed.Results The complete remission rate,progress rate and total efficiency were 17.0％ (9/53),11.3％ (6/53),73.6％ ( 39/53 ) in observation group,2.0％( 1/49 ),28.6％ (14/49),51.0％(25/49 ) in control group.There were significant differences between two groups (P ＜ 0.05).There was no statistical significance in adverse reactions between two groups ( P ＞ 0.05 ).The survival rates of the 1 st,2nd and 3rd year in control group were 51.0％ ( 25/49 ),28.6％(14/49),14.3％(7/49),the median survival time was 15 months;while those in observation groupwere 71.7％(38/53),52.8％(28/53),39.6％(21/53) and 20 months.The survival rates of the 2nd and 3rd year in observation group were significantly higher than those in control group respectively (P ＜0.05 or ＜0.01 ).The rate of patients with no obvious serum AFP protein change between observation group [ 9.8％(4/41) ] and control group [ 31.6％(12/38) ] had statistical significance (P ＜ 0.05).Conclusion Hyper-fractionated 3DCRT combined with TACE for treating patients with inoperable primary liver cancer has good clinical efficacy,it is worthy of clinical practice.
