原发性肝癌三维适形放疗的临床研究.pdfVIP

· 538· 2008年6月第 13卷第6期 Chinese Clinical Oncology，Jun．2008，Vo1．13，No．6 原发性肝癌三维适形放疗的临床研究 361003 福建厦门 解放军174医院南京军区肿瘤中心 吴晓安，章志勇，严志彪，高春玲，陈建清，万幼峰，洪节约 【摘 要】 目的：观察评价三维适形放射治疗技术(3DCRT)治疗原发性肝癌的有效性和安全性。方法：单试验组、开放 性临床研究，共入组44例原发性肝癌，均为病理明确诊断的初治患者，肿瘤直径5cm者6例、5～10cm者23例、10cm者 15例。单次剂量3～4Gy，每周3～4次，DT 36～60Gy。按照WHO标准评价客观疗效，正常组织反应按美国肿瘤放射治疗协 作组(RTOG)标准评价。结果：44例患者中，可评价疗效患者有43例，其中CR 3例，PR 25例，NC 10例，PD 5例，有效率(RR) 为65．1％；疾病控制率(DCR)为88．4％。1丫rP为52～662天，中位1TrP为306天，1年生存率为62．8％。主要毒副反应为可逆 性近期轻度胃肠道反应和骨髓抑制，放疗中肝脏放射损伤1级3例，1例有乙肝病史患者于放疗结束6个月时出现严重肝功 能损害。结论：三维适形放射治疗原发性肝癌能延长生存，提高生活质量，毒副作用可控制。 【关键词】 原发性肝癌；放射治疗；三维适形放射治疗 中图分类号：R730．55；R735．7 文献标识码：A 文章编号：1009一o460(2008)06—0538—03 Clinical study of three-dimensional conformal radiation therapy for primary hepatoellular carcinoma WU Xiao—an，zHANG Zhi一了ong，YAN Zhi—biao，GAO Chun—ling，CHEN Jian—qing，WAN You ng，HoNG Jie—yue．Cancer Center，P 174 Hospital，Xiamen 361003，China 【Abstract】 0bjective：To observe the efficacy and safety of three—dimensional conformal radiotherapy(3 DCRT)for primary hepatocellular carcinoma．Methods：In this open—label，single group trial，44 patients with histologically proven and previously untreated primary hepatocellular carcinoma were enrolled，including 36 male and 8 female patients．The median age was 53(range，36 to 75) years old．Diameter of 6 tumor targets was less than 5cm，of 23 tumor targets was 5-10cm，of 15 tumor targets was more than 10cm． The patients were irradiated at 3-4Gy fraction．3-4 fractions per week to a total dose of 36-60Gy．The curative effect was appraised ac— cording to WHO stardard，acute and chronic and chronic normal tissue effects were graded according to the Radiation Therapy Oncology Group(RTOG)radiation morbidity scoring criteria．Results：Forty—three patients were evaluable for response，in which 3 achieved complete response(CR)and 25 partial responses(PR)，namely