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目的研究放疗联合介入治疗肝细胞肝癌的方法。方法本组26例不能手术切除的肝细胞肝癌患者采用外放疗与介入联合治疗,外放疗用6MV加速器,适形放疗常规分割,每次剂量为180～200cGy,每周5次。总剂量4000～5600cGy,在放疗的同时进行介入治疗,介入治疗采用经皮一股动脉的Seldinger插管方法 ,将导管超选至肿瘤部位进行栓塞灌注,栓塞用超液化碘油10～20ml。灌注药物用5-氟尿嘧啶100mg,顺铂60mg,阿霉素40～50mg。结果 6例完全缓解,11例部分缓解,5例稳定,4例恶化,总有效率84.6%,随访4～24个月,生存1～6个月26例,生存6～12个月18例,生存12～24个月16例,中位生存期14个月。1a和2a的生存率分别为69.2%和61.5%。结论放疗联合介入治疗是治疗肝细胞肝癌有效的、安全的方法。
Objective To study the radiotherapy combined with interventional treatment of hepatocellular carcinoma. Methods The group of 26 patients with unresectable hepatocellular carcinoma were treated with external beam radiotherapy and interventional radiotherapy. External beam radiotherapy was performed with 6MV accelerator and conventional conformal radiotherapy. The dose was 180 ~ 200cGy per dose, 5 times a week. The total dose of 4000 ~ 5600cGy, radiotherapy interventional treatment at the same time, interventional therapy using percutaneous aorta Seldinger intubation method, the catheter over-selected to the tumor site embolization, embolization of ultra-liquefied iodized oil 10 ~ 20ml. Perfused drugs with 5-fluorouracil 100mg, cisplatin 60mg, doxorubicin 40 ~ 50mg. Results 6 cases were completely relieved, 11 cases were partially relieved, 5 cases were stable and 4 cases were deteriorated. The total effective rate was 84.6%. The follow-up ranged from 4 to 24 months, 26 cases survived from 1 to 6 months, 18 cases survived from 6 to 12 months, 16 cases survive 12 to 24 months, the median survival of 14 months. The survival rates of 1a and 2a were 69.2% and 61.5% respectively. Conclusion Radiotherapy combined with interventional therapy is an effective and safe method for the treatment of hepatocellular carcinoma.