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目的探讨介入治疗联合三维适形放射治疗(3DCRT)和调强适形放射治疗(IMRT)综合治疗中晚期肝癌的临床疗效。方法将66例中晚期肝癌患者随机分为观察组(33例)和对照组(33例),对照组患者行肝动脉化疗栓塞(TACE)联合3DCRT治疗,观察组患者行TACE联合IMRT治疗,比较两组患者临床指标的变化、近期疗效和药物不良反应。结果治疗后,观察组患者AFP水平变化优于对照组患者,观察组患者肿瘤大小明显小于对照组患者,差异均有统计学意义(均P<0.05),观察组患者治疗总有效率(93.9%)明显高于对照组患者(75.8%),差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论肝动脉化疗栓塞联合调强放射治疗综合治疗中晚期肝癌临床疗效确切,优于肝动脉化疗栓塞联合三维适形放射治疗,具有安全高效和不良反应少等特点,值得进一步推广。
Objective To investigate the clinical effects of interventional therapy combined with three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated conformal radiotherapy (IMRT) in the treatment of advanced hepatocellular carcinoma. Methods Sixty-six patients with advanced hepatocellular carcinoma (HCC) were randomly divided into observation group (33 cases) and control group (33 cases). Patients in the control group received TACE combined with 3DCRT. Patients in the observation group underwent TACE combined with IMRT. Two groups of patients with changes in clinical indicators, the recent efficacy and adverse drug reactions. Results After treatment, the change of AFP level in the observation group was better than that in the control group. The tumor size in the observation group was significantly smaller than that in the control group (all P <0.05), and the total effective rate in the observation group was 93.9% ) Was significantly higher than that of the control group (75.8%), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions The combination of transcatheter hepatic artery chemoembolization and intensity modulated radiotherapy in the treatment of advanced hepatocellular carcinoma is more effective than transcatheter arterial chemoembolization combined with three-dimensional conformal radiotherapy. It is safe and effective and has few adverse reactions. It is worth further promotion.