TACE联合3DCRT治疗肝癌伴门静脉癌栓疗效分析

摘要

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization( TACE )combined with three - dimensional conformal radiotherapy ( 3DCRT ) in the treatment for primary hepatocellular carcinoma with portal vein tumor thrombus ( PVTT ). Methods: From 2004 to 2009,32 patients with PVTT of hepatocellular carcinoma were treated with TACE combined with 3 DCRT in our department. The objective responses were analyzed and the survival rates were assessed from the date of the begining of treatment using Kaplan - Meier method.Results: The overall response rate of HCC was 71.9％. The remission rate of PVTT was 81.3％. The mean survival time was 20.63 ± 1.23 months, the median survival time was 19.0 ± 1.02 months. Multivariate analysis revealed the phase of tumor, type of PVTT , Child - Pugh class, Karnofsky grade were independent prognostic factors for the survival probability of patients ( P ＜ 0. 05 ). Conclusion: TACE combined with 3DCRT is an effective, feasible approach in the treatment of portal vein tumor thrombus in hepatocellular carcinoma.%目的:分析肝动脉化疗栓塞( TACE) 结合三维适形放射治疗对原发性肝癌(HCC)并门静脉癌栓(PVVT)的疗效.方法:2004年10月至2009年10月,共收治32例HCC合并PVVT患者,采用肝动脉化疗栓塞联合三维适形放射治疗,观察肿瘤及癌栓的近期疗效,用Kaplan-Meier法进行生存分析,采用Cox比例风险模型作多因素分析.结果:原发灶肿瘤近期有效率71.9%,癌栓有效率为81.3%.平均生存时间为20.63±1.23个月,中位生存时间为19.0±1.02个月.多因素分析显示肿瘤分期、癌栓类型、肝功Child-Pugh分级、卡氏评分是影响预后的主要因素(P<0.05).结论:TACE联合3DCRT治疗肝癌合并PVTT疗效好,损伤小,易耐受,是治疗HCC合并PVTT有效治疗方法.