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目的 比较术中肝动脉栓塞化疗加超分割放射治疗与单纯肝动脉栓塞治疗不能切除的原发性肝癌的疗效。方法 对 91例手术探查不能切除的原发性肝癌随机分为 2个组 :术中肝动脉栓塞加超分割放射治疗组 (IHAE +HR) 4 3例 ,单纯术中肝动脉栓塞组 (IHAE) 4 8例。肝动脉化疗选用40 %碘化油≤ 2 0mL +顺铂 2 0～ 40mg、阿霉素 40～ 80mg、丝裂霉素 10～ 2 0mg、氟尿嘧啶 10 0 0～15 0 0mg。栓塞选用注入明胶海绵碎粒及结扎肝动脉方法。超分割放射治疗方法为 12 0cGy/次 ,2次/d ,间隔 6h ,总剂量 40 0 0～ 5 0 0 0cGy ,3～ 4周。 结果 IHAE +HR组和IHAE组的 1,3,5年生存率分别为 72 .9% ,35 .6 % ,2 8.5 %和 5 2 .0 % ,11.8% ,4.6 % ,2个组差异有显著意义 (P <0 .0 5 )。结论 术中肝动脉栓塞化疗加超分割放射治疗能有效地控制不能切除的原发性肝癌发展 ,提高了生存率 ,是一种比较好的综合治疗方法。
Objective To compare the efficacy of intraoperative hepatic artery embolization plus hyperfractionated radiotherapy and simple hepatic artery embolization in the treatment of unresectable primary liver cancer. Methods Ninety-one cases of unresectable primary liver cancer were randomly divided into two groups: intraoperative hepatic artery embolization plus hyperfractionated radiotherapy group (IHAE + HR): 43 cases, and intraoperative hepatic artery embolization group (IHAE). 48 cases. Hepatic arterial chemotherapy used 40% iodized oil ≤ 20 mL + cisplatin 20-40 mg, doxorubicin 40-80 mg, mitomycin 10-20 mg, and fluorouracil 100-150 mg. The embolism was selected by injecting gelatin sponge and ligating the hepatic artery. Hyperfractionated radiation therapy was performed at 12 0cGy/time, 2 times/d, 6h interval, and total dose 400-500 kGy for 3 to 4 weeks. Results The 1-, 3-, 5-year survival rates of IHAE + HR group and IHAE group were 72.9%, 35.6 %, 28.5% and 52.0%, 11.8%, and 4.6%, respectively. Significant (P <0. 0 5). Conclusion Intraoperative hepatic artery embolization chemotherapy combined with hyperfractionated radiotherapy can effectively control the development of unresectable primary liver cancer and improve the survival rate. It is a relatively good comprehensive treatment method.