CAJ | 학술논문

目的：观察三维适形放疗联合肝动脉化疗栓塞术治疗原发性肝癌伴门静脉癌栓的疗效。方法50例不能手术切除的PHC伴PVTT患者随机分为2组，A组根据癌栓位置先行TACE治疗1～2次，1～4周后行3DCRT，或先行3DCRT，1～2周后再行TACE治疗1～2次；B组仅行TACE治疗1～2次。大体肿瘤体积（ GTV）仅包括癌栓，照射剂量为40～50 Gy，单次剂量为2～3 Gy，5次/周。比较两组疗效及不良反应。结果 A组1年生存率为28％，中位生存时间为10．3个月，有效率（CR＋PR）为36％；B组1年生存率为24％，中位生存时间10．0个月，有效率为24％；P＞0．05。结论3DCRT联合TACE治疗原发性肝癌伴PVTT疗效略优于TACE，但无统计学差异。
목적：관찰삼유괄형방료연합간동맥화료전새술치료원발성간암반문정맥암전적료효。방법50례불능수술절제적PHC반PVTT환자수궤분위2조，A조근거암전위치선행TACE치료1～2차，1～4주후행3DCRT，혹선행3DCRT，1～2주후재행TACE치료1～2차；B조부행TACE치료1～2차。대체종류체적（ GTV）부포괄암전，조사제량위40～50 Gy，단차제량위2～3 Gy，5차/주。비교량조료효급불량반응。결과 A조1년생존솔위28％，중위생존시간위10．3개월，유효솔（CR＋PR）위36％；B조1년생존솔위24％，중위생존시간10．0개월，유효솔위24％；P＞0．05。결론3DCRT연합TACE치료원발성간암반PVTT료효략우우TACE，단무통계학차이。
Objective To explore the clinical efficacy of three-dimensional conformal radiotherapy (3DCRT) combined with transcatheter arterial chemoembolization ( TACE) for portal vein tumor thrombus ( PVTT) in primary hepatocellular carcinoma (PHC).Methods 50 PHC patients with portal vein tumor thrombus were randomly divided into 2 groups.Group A(n=50)re-ceived TACE for 1~2 times,and 1~4 weeks later they received 3DCRT,or they received 3DCRT first,and 1~2 weeks later they received TACE for 1~2 times.Group B was treated with TACE for 1~2 times.Gross tumor volume(GTV)was defined as PVTT only,DT 40-50 Gy,2-3 Gy/f,5 f/w.Therapeutic efficacy and side effects of the 2 groups were compared with .Results In group A,1-year survival rate was 28%,median survival time(MST)was 10.3 months,and total effective rate was 36%;in the group B, 1-year survival rate was 24%,MST was 10.0 months,and the total effective rate was 24%.Conclusion Efficacy of 3DCRT plus TACE for primary hepatocellular carcinoma is superior to TACE .