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目的评价三维适形放疗同步化疗方案治疗原发性肝癌的临床疗效。方法将61例原发性肝癌患者随机分为治疗组和对照组,治疗组31例,给予三维适形放疗同步FOLFOX4(奥沙利铂+亚叶酸钙+5氟脲嘧啶)方案化疗,对照组30例,给予FOLFOX4方案化疗,观察两组患者的近期疗效、血清甲胎蛋白(AFP)变化、生存时间及不良反应。结果治疗组和对照组的治疗有效率分别为83.8%和60.0%,两组比较差异有统计学意义(P<0.05);治疗组AFP≥400μg/L的患者中由84.0%降至400μg/L,对照组AFP≥400μg/L的患者由59.1%降至<400μg/L,两组比较差异有统计学意义(P<0.05);治疗组的1～3年生存率分别为75.9%、58.6%和31.0%,对照组分别为60.7%、39.3%和17.9%,两组比较差异有统计学意义(P<0.01);两组的不良反应主要表现为胃肠道反应、骨髓抑制、肝功能损伤和手足综合征,两组比较差异无统计学意义。结论三维适形放疗同步FOLFOX4方案治疗原发性肝癌的能提高近期疗效、降低AFP,延长生存时间。
Objective To evaluate the clinical efficacy of three-dimensional conformal radiotherapy (CCT) in the treatment of primary liver cancer. Methods Sixty-one patients with primary liver cancer were randomly divided into treatment group and control group, with 31 cases in treatment group and three-dimensional conformal radiotherapy with concurrent FOLFOX4 chemotherapy (oxaliplatin + leucovorin + 5 fluorouracil) Thirty patients were given FOLFOX4 regimen. The curative effect, AFP level, survival time and adverse reactions of the two groups were observed. Results The effective rates of the treatment group and the control group were 83.8% and 60.0%, respectively, with significant difference between the two groups (P <0.05). In the treatment group, the effective rate of the treatment group was decreased from 84.0% to 400μg / L , The control group AFP≥400μg / L patients decreased from 59.1% to <400μg / L, the difference between the two groups was statistically significant (P <0.05); 1 to 3-year survival rates were 75.9%, 58.6% And 31.0% in the control group, 60.7% in the control group, 39.3% in the control group and 17.9% in the control group respectively (P <0.01). The adverse reactions of the two groups were mainly gastrointestinal reaction, myelosuppression and liver injury And hand-foot syndrome, no significant difference between the two groups. Conclusion The three-dimensional conformal radiotherapy synchronized FOLFOX4 regimen for the treatment of primary liver cancer can improve the short-term efficacy, reduce AFP and prolong the survival time.