原发性肝癌合并门静脉癌栓术后肝动脉栓塞化疗联合三维适形放疗的疗效观察.docVIP

原发性肝癌合并门静脉癌栓术后肝动脉栓塞化疗联合三维适形放疗的疗效观察 　　[摘要] 目的 探讨原发性肝癌合并门静脉癌栓（PVTT）患者取栓术后肝动脉栓塞化疗（TACE）联合三维适形放疗（3-DCRT）的临床疗效。 方法 选取2009年1月～2012年1月本院收治的47例原发性肝癌合并PVTT患者作为研究对象，随机分为TACE组（21例）与TACE联合3-DCRT组（26例），比较两组的术后肿瘤复发率及生存率。 结果 TACE联合3-DCRT组的肿瘤复发率显著低于TACE组，复发时间显著长于TACE组，差异有统计学意义（P0.05）。TACE联合3-DCRT组的总生存率显著高于TACE组，中位生存期显著长于TACE组，差异有统计学意义（P0.01）。 结论 TACE联合3-DCRT在原发性肝癌合并PVTT患者取栓术后的应用效果显著，能够降低肿瘤复发率，提高总生存率，延长患者生存时间。 　　[关键词] 原发性肝癌；门静脉癌栓；肝动脉栓塞化疗；三维适形放疗 　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0064-04 　　[Abstract] Objective To explore the clinical effect of transcatheter arterial chemoembolization （TACE） combined with three-dimensional conformal radiotherapy （3-DCRT） in postoperative primary hepatocellular carcinoma and portal vein tumor thrombus （PVTT）. Methods 47 patients with primary hepatocellular carcinoma and PVTT from January 2009 to January 2012 in our hospital were selected and randomly divided into the TACE group （21 cases） and the TACE combined with 3-DCRT group （26 cases）.The postoperative tumor recurrence rate and survival rate was compared between the two groups. Results The tumor recurrence rate in the TACE combined with 3-DCRT group was lower than that in the TACE group，recurrence time in the TACE combined with 3-DCRT group was longer than that in the TACE group，with significant difference （P0.05）.The total survival rate in the TACE combined with 3-DCRT group was higher than that in the TACE group，the median survival time in the TACE combined with 3-DCRT group was longer than that in the TACE group，with significant difference （P0.01）. Conclusion The application effect of TACE combined with 3-DCRT in postoperative primary hepatocellular carcinoma and PVTT is significant，which can reduce the rate of tumor recurrence and improve overall survival，prolong survival time of patient. 　　[Key words] Primary hepatocellular carcinoma；Portal vein tumor thrombus；Transcatheter arterial chemoembolization；Three-dimensional conformal radiotherapy肝癌发病隐匿，进展迅速，70%～80%的病例就诊时