简化调强放疗联合肝动脉化疗栓塞治疗原发性肝癌的临床研究

目的 探讨常规调强与简化调强两种不同放疗技术联合经导管肝动脉化疗栓塞术(TACE)治疗原发性肝癌(PHC)的临床疗效与安全性.方法 将符合条件的85例PHC患者分为观察组(n=43)和对照组(n=42).观察组采用 TACE联合简化调强放疗技术(sIM RT )行序贯治疗 ,对照组采用 T ACE联合常规调强放疗技术(cIM RT )行序贯治疗.观察两组患者近期疗效、疾病无进展生存时间(PFS )、总体生存时间(OS )和毒副反应发生情况.结果 85例患者均按要求进行随访 ,对照组有2例未完成放疗计划而未参与疗效评价.观察组与对照组近期疗效(55 .81% vs .52 .50% )、PFS(25 .51周 vs .28 .06周)和OS(78 .82周 v s .83 .22周)比较 ,均差异无统计学意义( P＞0 .05 ).两组主要毒副反应相似 ,各项比较也均差异无统计学意义( P＞0 .05 ) ,其中观察组放射性肝损伤较对照组发生率有降低的趋势.结论 sIM RT 相对于cIM RT 可以获得近似疗效和预后 ,于治疗中及治疗后未增加毒副反应 ,还有减少发生放射性肝损伤的趋势 ,可作为PHC调强放疗计划设计的常规替代方式.

Clinical study on simplified intensity modulated radiotherapy plus TACE for treating primary hepatic cancer

Objective To observe the clinical curative effecand safety of ordinary intensity modulated and simplified intensi-ty modulated radiotherapy technique combined with transcathetearterial chemoembolization (TACE) fotreating primary hepaticancer(PHC) .MethodTotally 85 caseof Phwere randomly divided into the observation group (n=43) and the control group (n=42) .The observation group adopted the sequential therapy of TACE combined with the simplified intensity modulated radio-therapy(sIMRT) and the control group adopted the sequential therapy of TACE combined with the conventional intensity-modula-ted radiation therapy (cIMRT) .The shorterm curative effect,progresfree survival (PFS) ,overall survival (OS) ,and toxicity and adverse reactionwere observed in the two group.Result85 casewere followed up according to the requirement,2 casein the control group did noparticipated in the effecevaluation due to the unfinished radiotherapy projec.There were no statistically significandifferencebetween the two groupin the shorterm effect(55 .81% v.52 .50% ) ,PFS(25 .51 weekv.28 .06 weeks) and OS(78 .82 weekv.83 .22 weeks) (P＞0 .05) .The main toxicity and adverse reactionwere similain the two group,each i-tem had no statistical difference between the two group(P>0 .05) .Conclusion sIMRcan obtain the curative effecand progno-sisimilato cIMRwithouincreasing the toxicity and adverse reaction,and reducethe trend developing radioactive livedam-age ,which can be used athe routine replace mode of intensity modulated radiotherapy projecof PHC.