Analysis of the Curative Effect of Interventional Therapy Plus 3 Dimensional Conformal Radiation Therapies for Hepatic Cell Carcinoma_West China Medical Journal

Authors：

ZHAO Caixia ¹ , REN Yongjun ² , WEN Shiming ¹ , et al ¹

1Department of Tumor, Nanchong Central Hospital, Nanchong Sichuan 637000; 2 Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong Sichuan 637000, China;

Corresponding author：

Keywords：

原发性肝细胞癌; 三维适形放射治疗; 栓塞,灌注化疗

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目的:探讨经导管肝动脉灌注化疗栓塞(TACE)与TACE联合三维适形放射治疗(TACE + 3DCRT)原发性肝细胞癌(HCC)的疗效.方法:随机分成两组的HCC患者,均不能手术、门脉无癌栓、无远处脏器转移。50例患者行单纯TACE 2次(TACE组)。40例患者在TACE 2次后第四周再行三维适形放射治疗(TACE + 3DCRT组),放疗采用6MVX射线,4～6 Gy/次,隔日一次,3次/周,总剂量45～60 Gy。TACE采用碘化油、顺铂、5氟尿嘧啶、表阿霉素及明胶海绵。结果:TACE组与TACE+3DCRT组近期疗效有效率(完全缓解+部分缓解)分别为68.0%(34/50)、87.5%(35/40),1年生存率分别为78.0%(39/50)、95.0%(38/40),两组差异均有统计学意义(P lt;0.05)。TACE的治疗反应主要为栓塞综合征,3DCRT有7.5%(3/40)发生急性放射性肝炎,经对症、保肝处理后缓解。两组患者均能耐受。结论:TACE + 3DCRT治疗不能手术、门脉无癌栓、无远处脏器转移的HCC的疗效较单纯TACE治疗HCC的疗效好。

Citation： ZHAO Caixia,REN Yongjun,WEN Shiming,et al. Analysis of the Curative Effect of Interventional Therapy Plus 3 Dimensional Conformal Radiation Therapies for Hepatic Cell Carcinoma. West China Medical Journal, 2009, 24(7): 1686-1689. doi: Copy

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11.	邓瑜萍, 杨志刚, 谢建国,等. 原发性肝癌介入治疗并发症原因分析和对策[J]. 华西医学, 2006, 21(2):298-299.
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1. TAIEB J, BARBARE J C, BOUSSAHA T, et al. Management of hepatocellular carcinoma. Where are we now? What’s next? [J] Bull Cancer, 2009, 96(1):19-34.
2. ZENG W, GOUW A S, VAN DEN HEUVEL M C, et al. The angiogenic makeup of human hepatocellular carcinoma does not favor vascular endothelial growth factor/angiopoietindriven sprouting neovascularization [J]. Hepatology, 2008,48(5):1517-1527.
3. LUBIENSKI A, SIMON M, LUBIENSKI K, et al. Update on chemoinfusion and chemoembolization treatments.Radiologe [J]. 2007,47(12):1097-1106,1108.
4. WANG B, XU H, GAO Z Q, et al. Increased expression of vascular endothelial growth factor in hepatocellular carcinoma after transcatheter arterial chemoembolization. Acta Radiol [J]. 2008,49(5):523529.
5. MIRAGLIA R, PIETROSI G, MARUZZELLI L, et al.Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma. World J Gastroenterol [J]. 2007, 13(21):2952-2955.
6. LIANG S X, ZHU X D, XU Z Y,et al. Radiationinduced liver disease in threedimensional conformal radiation therapy for primary liver carcinoma:the risk factors and hepatic radiation tolerance [J]. Int J Radiat Oncol Biol Phys, 2006, 65(2):426-434.
7. TSE R V, HAWKINS M, LOCKWOOD G, et al. Phase I study of individualized stereotactic body radiotherapy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma [J]. J Clin Oncol, 2008, 26(4):657-664.
8. IGAKI H, NAKAGAWA K, SHIRAISHI K, et al.Threedimensional conformal radiotherapy for hepatocellular carcinoma with inferior vena cava invasion [J]. Jpn J Clin Oncol. 2008, 38(6):438-444.
9. CHIAHSIEN CHENG J, CHUANG VP, CHENG SH, et al. Unresectable hepatocellular carcinoma treated with radiotherapy and/or chemoembolization [J]. Int J Cancer, 2001, 96(4):243-252.
10. LI B, YU J, WANG L, et al. Study of local threedimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for patients with stage III hepatocellular carcinoma [J]. Am J Clin Oncol, 2003, 26(4):e92-e99.
11. 邓瑜萍, 杨志刚, 谢建国,等. 原发性肝癌介入治疗并发症原因分析和对策[J]. 华西医学, 2006, 21(2):298-299.
12. KIM T H, KIM D Y, PARK J W, et al. Dosevolumetric parameters predicting radiationinduced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with threedimensional conformal radiotherapy [J]. Int J Radiat Oncol Biol Phys, 2007, 67(1):225-231.

West China Medical Journal

Analysis of the Curative Effect of Interventional Therapy Plus 3 Dimensional Conformal Radiation Therapies for Hepatic Cell Carcinoma

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