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目的 探讨立体定向适形放疗 (SCRT)加肝动脉栓塞化疗 (TACE)对中晚期原发性肝癌的治疗效果。方法 将 1 0 4例中晚期原发性肝癌随机分为两组 ,TACE+SCRT(综合组 ) ,和单纯 TACE(对照组 )各 5 2例 ,综合组先予羟基喜树碱、5 -Fu、DDP和超液化碘油行 TACE,2周后行 SCRT,使用 8mvx线 ,4～ 8Gy/f,共照 8～ 1 5次 ,隔日照射 ,使90 %等剂量线包完 90 %的肝癌体积 ;对照组 1、3、6月各行 TACE1次 ,共治疗 3次。结果 综合组近期疗效 (CR+PR)为88.6% ,对照组为 5 7.6% ,综合组与对照组有显著性差异 (P <0 .0 1 )。综合组、对照组的 1 2、1 8和 2 4个月生存率分别为71 .1 %、5 5 .8%和 3 8.5 % ,5 0 .0 %、2 5 .0 %和 1 9.2 % ,综合组明显优于对照组 (P <0 .0 1 )。两组副反应无显著性差异 (P>0 .0 5 ) ,病人能耐受。结论 TACE+SCRT治疗中晚期原发性肝癌是安全有效的方法之一
Objective To investigate the therapeutic effect of stereotactic conformal radiotherapy (SCRT) plus hepatic arterial chemoembolization (TACE) on advanced primary liver cancer. Methods One hundred and four cases of primary hepatocellular carcinoma (HCC) were randomly divided into two groups: TACE + SCRT (combination group) and TACE alone (control group), with 52 cases in each group. The combination group was given hydroxycamptothecin , DDP and hyperlipemia lipiodol TACE, two weeks after the SCRT, using 8mvx line, 4 ~ 8Gy / f, a total of 8 to 15 times, the next day irradiation, 90% of the dose line complete 90% of the liver cancer volume; Group 1, 3, 6 months TACE1 times, a total of 3 times. Results The curative effect (CR + PR) of the combined group was 88.6% and that of the control group was 7.66%. There was a significant difference between the combined group and the control group (P <0.01). The 1, 2, 18 and 24-month survival rates in the combined group and control group were 71.1%, 55.8% and 38.5%, 50.0%, 25.0% and 12.2%, respectively , The comprehensive group was significantly better than the control group (P <0. 01). No significant difference between the two groups of side effects (P> 0.05), the patient can tolerate. Conclusion TACE + SCRT in the treatment of advanced primary liver cancer is one of the safe and effective methods