【摘要】 目的 探讨三维适形放疗(3DCRT)联合介入栓塞化疗(TACE)治疗Ⅲ、Ⅳ期原发性肝癌的方法和临床价值。 方法 回顾性总结2006年6月-2008年12月采用3DCRT联合TACE治疗原发性肝癌的临床资料40例。 结果 3DCRT联合TACE治疗Ⅲ、Ⅳ期原发性肝癌有效率为85%。0.5、1、2年局部控制率分别为92%、70%、52%。0.5、1、2年生存率分别为75%、46%、30%，治疗不良反应轻微。 结论 3DCRT联合TACE能提高原发性肝癌患者生活质量，延长生存期,是治疗中晚期原发性肝癌的有效治疗方法之一。【Abstract】 Objective To investigate the application and clinical value of three-dimensional conformal radiation therapy (3DCRT) combined with transcatheter arterial chemoembolization (TACE) on stage Ⅲ and Ⅳ primary hepatic carcinoma. Methods A Total of 40 cases of stage Ⅲ and Ⅳ primary hepatic carcinoma treated by 3DCRT combined with TACE from June 2006 to December 2008 were analyzed retrospectively. Results The response rate was 85%. The 0.5-, 1-, and 2-year local response rates were 92%, 70%, and 52%, and the 0.5-, 1-, and 2-year survival rates were 75%, 46%, and 30%, respectively. The adverse reactions of radiotherapy were tolerable. Conclusion 3DCRT combined with TACE could improve prognosis of stage Ⅲ and Ⅳprimary hepatic carcinoma.
目的：探讨ⅢA-N2期非小细胞肺癌（NSCLC）完全切除术后三维适形放疗联合辅助化疗疗效。方法:对48例ⅢA-N2期NSCLC完全切除术后患者，术后病理为腺癌18例、鳞癌27例、腺鳞癌3例，按信封法随机分为放疗组（24例）与非放疗组（24例）。放疗组采用术后三维适形放疗，4～5个非共面野，以90%～95%等剂量曲线包绕PTV，每次2 Gy，1次/日，5次/周，共照射25次，总剂量DT 50 Gy，放疗后予TP方案化疗3~4周期；非放疗组术后予TP方案化疗3~4周期。结果：放疗组1、2、3年生存率分别为95.8%、79.2%、62.5%，非放疗组分别为91.7%、58.3%、37.5%；放疗组1、2、3年无病生存率分别75.0%、58.3%、45.8%，非放疗组分别为54.2%、41.7%、25.0%；放疗组与非放疗组3年胸腔内复发分别12.5%和37.5%；放疗组与非放疗组中位生存时间分别为28个月和18个月；放疗组白细胞减少、急性放射性肺炎、气管炎发生率分别为25.0%、8.3%、12.5%，均为Ⅰ或Ⅱ级；Ⅰ级急性放射性食管炎发生率为20.8%。结论：ⅢA-N2期非小细胞肺癌完全切除术后三维适形放疗联合辅助化疗，可以降低患者胸腔内肿瘤复发、提高术后生存率。
目的:评价70岁以上老年非小细胞肺癌患者大分割放疗的长期疗效和并发症。方法:对1997年8月至2003年2月收治的38例70岁以上非小细胞肺癌实施大分割三维适形放疗(3D-CRT),年龄70～85岁,中位年龄74岁。全组卡氏评分均≥70。其中Ⅰ期8例, Ⅱ期20例, Ⅲ期8例,Ⅳ期2例。结果:全组有效率(CR+PR)92.1%;1,2,3,5年生存率分别为94.7%、65.7%、38.9% 和 28.0%。1,2 级急性放射性食管炎发生率 47.4%(18/38);未出现急性症状性放射性肺炎,未发现严重心脏、食管、脊髓放射性反应。晚期局部肺放射性纤维化表现(CT和/或胸片)为34.2%(13/38).结论:不能手术的老年非小细胞肺癌患者大分割适形放射治疗,安全有效,副作用可以耐受。
ObjectiveTo systematically review efficacy and safety of docetaxel chemotherapy combine with 3-dimensional conformal radiation therapy (3D-CRT) in treatment of esophageal cancer.MethodsDatabases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI and WanFang Data were searched from inception to February 2017 to collect randomized controlled trials (RCTs) and quasi-randomized control trials (qRCTs) about docetaxel chemotherapy combine with 3D-CRT in treatment of esophageal cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Stata 12.0 software.ResultsA total of 17 RCTs involving 1 353 patients were included. The results of meta-analysis showed that, compared with the radiotherapy alone, the docetaxel chemotherapy combine with 3D-CRT could improve effective rate (OR=1.25, 95%CI 1.07 to 1.47, P=0.003), 3-year survival rate (OR=1.91, 95%CI 1.19 to 3.06, P=0.006), but there were no significant differences in 1-year survival rate (OR=1.28, 95%CI 0.95 to 1.72, P=0.105), hematologic toxicities (OR=1.13, 95%CI 0.85 to 1.49, P=0.389) and gastrointestinal reactions (OR=1.19, 95%CI 0.90 to 1.57, P=0.181).ConclusionsCompared with radiotherapy alone, docetaxel chemotherapy combine with 3D-CRT can improve the effective rate, 3-year survival rate, but not increase the incidences of adverse effects. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusion.