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目的研究三维适形放疗(3DCRT)联合肝动脉化疗栓塞(TACE)对Ⅲ、Ⅳ期原发性肝癌的疗效。方法80例Ⅲ、Ⅳ期原发性肝癌患者随机分为2个组,40例采用3DCRT+TACE,40例采用3DCRT+肝动脉插管药物灌注(HAI)。结果3DCRT联合TACE组与3DCRT联合HAI组有效率分别为75%和45%(P<0·05)。3DCRT+TACE组0·5、1·0、2·0年局部控制率分别为93%、85%、61%,明显高于3DCRT+HAI组的70%、43%、33%(P<0·05)。远处转移率3DCRT+TACE组与3DCRT+HAI组分别为30%和38%(P>0·05)。3DCRT+TACE组0·5、1·0、2·0年生存率分别为73%、45%、28%,高于3DCRT+HAI组的45%、25%、13%(P<0·01)。毒副反应结果显示治疗组与对照组相似(P>0·05)。结论3DCRT+TACE能提高Ⅲ、Ⅳ期原发性肝癌疗效,是中晚期原发性肝癌行之有效的治疗方法。
Objective To study the effect of three-dimensional conformal radiotherapy (3DCRT) and transcatheter arterial chemoembolization (TACE) on stage Ⅲ and Ⅳ primary liver cancer. Methods Eighty patients with stage Ⅲ and Ⅳ primary hepatocellular carcinoma were randomly divided into two groups. 40 cases were treated with 3DCRT + TACE and 40 cases were treated with 3DCRT + hepatic arterial infusion (HAI). Results The 3DCRT combined TACE group and 3DCRT combined with HAI group were 75% and 45% effective (P <0.05). The local control rates in 3DCRT + TACE group were 93%, 85% and 61% at 0, 5 and 1.0 years respectively, which were significantly higher than 70%, 43% and 33% in 3DCRT + HAI group · 05). The distant metastasis rate was 30% in the 3DCRT + TACE group and 38% in the 3DCRT + HAI group (P> 0.05). The survival rates of 0 · 5,1 · 0,0 · 0,03 years in 3DCRT + TACE group were 73%, 45%, 28%, respectively, which were higher than 45%, 25%, 13% of 3DCRT + HAI group ). Toxicity results showed that the treatment group and control group similar (P> 0.05). Conclusion 3DCRT + TACE can improve the efficacy of stage Ⅲ, Ⅳ primary liver cancer and is an effective treatment for advanced primary liver cancer.