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目的探讨术后后装放疗加吉西他滨全身化疗对原发性肝癌的治疗效果。方法1999年10月-2001年12月,将44例行肝癌切除术的原发性肝癌患者随机分为综合治疗组和对照组,每组22例。综合治疗组术中放置施源管3-6根,确定驻留点3-8个,术后3-10天行后装放疗,单次剂量10Gy,照射2～4次,总剂量20-40Gy。放疗结束3周后,开始吉西他滨化疗,静滴1.4g每周1次,4周为1周期,每周期3次,共6个周期。对照组手术后不放、化疗。手术前后定期查血常规、肝功能、AFP、胸片、B超或CT。结果综合治疗组后装放疗后AFP转阴率100%(17/17),对照组62.5%(10/16)(P<0.05);6月复发率0,低于对照组27.3%(6/22)(P<0.01);综合治疗组1年复发率18.2%(4/22)、转移率0和1年生存率100%(22/22),与对照组的45.5%(10/22)、13.6%(3/22)和77.3%(17/22)均有显著差异(P<0.05)。结论术后后装放疗加吉西他滨全身化疗是提高原发性肝癌近期治疗效果,降低复发率和转移率的有效手段。
Objective To investigate the therapeutic effect of postoperative radiotherapy and gemcitabine chemotherapy on primary liver cancer. Methods From October 1999 to December 2001, 44 patients with hepatocellular carcinoma who underwent resection of liver cancer were randomly divided into comprehensive treatment group and control group, with 22 cases in each group. In the comprehensive treatment group, 3-6 Shiyuan tubes were placed intraoperatively, 3-8 of them were confirmed, and postoperative radiotherapy was performed 3-10 days after operation. The single dose of 10 Gy and the irradiation of 2 to 4 times, the total dose of 20-40 Gy . Three weeks after the end of radiotherapy, gemcitabine chemotherapy is started. 1.4g intravenous infusion is given once a week for 4 weeks for 1 cycle and 3 cycles for 6 cycles. Control group after surgery, chemotherapy. Regular blood tests before and after surgery, liver function, AFP, chest X-ray, B ultrasound or CT. Results After treatment, the AFP negative rate was 100% (17/17) in the combined treatment group and 62.5% (10/16) in the control group (P <0.05). The recurrence rate in June was lower than that in the control group (27.3%, 6 / (P <0.01). The 1-year recurrence rate was 18.2% (4/22) in the comprehensive treatment group and 0 and 1 year survival rate was 100% (22/22) in the comprehensive treatment group, 45.5% (10/22) , 13.6% (3/22) and 77.3% (17/22) respectively (P <0.05). Conclusion Postoperative chemotherapy plus gemcitabine systemic chemotherapy is an effective way to improve the short-term treatment efficacy and reduce the recurrence rate and metastasis rate of primary liver cancer.