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目的:探讨肝动脉化疗栓塞术(TACE)联合三维适形放疗技术(3DCRT)治疗原发性肝癌(PHC)合并门静脉癌栓(PVTT)的临床疗效和安全性。方法:60例经病理组织学确诊的PHC伴PVTT患者随机分为观察组和对照组。观察组采用TACE联合3DCRT治疗,对照组单纯采用TACE治疗。疗程结束后评价近期疗效、观察毒副反应,随访1年评价客观疗效和生存率。结果:观察组近期疗效有效率为80.0%,高于对照组(43.3%)(P<0.05)。观察组患者随访期内有18例死亡,对照组患者随访期内有24例死亡;观察组中位疾病进展时间及1年生存率显著高于对照组(P<0.05)。两组患者对毒性反应均可耐受。结论:TACE联合3DCRT治疗PHC合并PVTT患者临床疗效肯定,毒副反应小,值得临床推广应用。
Objective: To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) and three-dimensional conformal radiotherapy (3DCRT) in the treatment of primary hepatocellular carcinoma (PHC) combined with portal vein tumor thrombus (PVTT). Methods: Sixty PHC patients with PVT diagnosed by histopathology were randomly divided into observation group and control group. The observation group was treated with TACE combined with 3DCRT and the control group with TACE alone. After the course of treatment evaluation of the recent curative effect, observe the side effects, follow-up 1 year evaluation objective curative effect and survival rate. Results: The effective rate of the observation group was 80.0%, higher than that of the control group (43.3%) (P <0.05). During the follow-up period, 18 patients died in the observation group and 24 patients died in the control group during the follow-up period. The median progression time and 1-year survival rate in the observation group were significantly higher than those in the control group (P <0.05). Toxicity of both groups of patients can tolerate. Conclusion: TACE combined with 3DCRT in patients with PHC combined with PVTT clinical efficacy of certain side effects, worthy of clinical application.