摘要
目的:观察三维适形放疗(3-DCRT)联合肝动脉化疗栓塞(TACE)治疗原发性肝细胞癌(HCC)伴门静脉癌栓(PVTT)的临床效果及不良反应。方法:64例HCC伴PVTT患者根据治疗意愿分为两组,对照组(n=32)仅采用TACE治疗,观察组(n=32)采用3-DCRT联合TACE治疗。观察两组治疗6个月后的临床疗效,详细记录两组治疗后第6、12、18及24个月时的生存率,比较两组患者治疗期间各种不良反应发生情况。结果:观察组治疗有效率(71.9%)明显高于对照组(53.1%),差异有统计学意义(P<0.05);观察组患者治疗后的第12、18及24个月的生存率(81.3%,65.6%,46.9%)均明显高于对照组(56.3%,31.3%,18.8%),差异均有统计学意义(P<0.05);两组白细胞计数下降、低热、肝肾功能损伤、胃肠道反应及肝区疼痛等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:3-DCRT联合TACE治疗HCC伴PVTT效果显著,可明显提高患者生存率,且不会增加不良反应发生率。
Objective:To observe the clinical efficacy and adverse reactions of three-dimensional conformal radiotherapy(3-DCRT)combined with transcatheter hepatic arterial chemoembolization(TACE)in the treatment of hepatocellular carcinoma(HCC)with portal vein tumor thrombosis(PVTT).Method:64 patients of HCC with PVTT were divided into two groups according to their treatment intentions,the control group(n=32)was treated with TACE only,and the observation group(n=32)was treated with 3-DCRT combined with TACE.The clinical efficacy of two groups after 6 months of treatment were observed,and the survival rate of 6,12,18,and 24 months after treatment of two groups were detailed recorded,and the incidence of adverse reactions in two groups of patients during treatment were compared.Result:The efficiency of observation group(71.9%)was significantly higher than that of the control group(53.1%),the difference was statistically significant(P<0.05).The survival rate in the observation group after 12,18,and 24 months(81.3%,65.6%,46.9%)were significantly higher than those of the control group(56.3%,31.3%,18.8%),the differences were statistically significant(P<0.05).There were no significant differences about decreased in the white blood cell count,fever,liver and kidney dysfunction,gastrointestinal reaction and liver area pain incidence of adverse reactions between two groups(P>0.05).Conclusion:The treatment of 3-DCRT combined with TACE for HCC with PVTT has a significant effect,can significantly improve the survival rate of patients,and does not increase the incidence of adverse reactions.
引文
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