Objective To evaluate the effect and tolerance of patients with hepatocellular carcinoma ( HCC) treated by γ - ray three -dimensional conformal radiotherapy ( 3 - DCRT) combined with interventional therapy or χ - ray Three Dimensional Conformal Radiation Therapy combined with interventional therapy. Methods From June 2005 to June 2008, 50 patients with HCC were randomly divided into γ - ray three - dimensional conformal radiotherapy ( 3 -DCRT) combined with interventional therapy group (n =25) and χ - ray three - dimensional conformal radiotherapy ( 3 - DCRT) combined with interventional therapy group ( n = 25 ). All the 50 cases were firstly treated with TACE. γ - ray 3 - DCRT was performed after 2-3 times of TACE in 25 cases and the remaining 25 cases were treated χ - ray 3 -DCRT after 2-3 times of TACE. Results The overall response rate of HCC was 84% in TACE combined with γ - ray 3 - DCRT group, significantly higher than that in - ray 3 - DCRT group ( 56% ) (P < 0.05 ). The total effective rate after three months and overall survival rates afterl, 2, 3 year in TACE combined with γ - ray 3 - DCRT group (76% and 45.9% ,20.4% , respectively) .while the other group (79.6%and30. 2%, 12.6% .respectively), P>0.05. Conclusion The overall response rate of HCC in γ - ray 3 - DCRT + TACE is better than χ- ray 3 - DCRT + TACE for HCC, but the overall survival rates is not significant.%目的 比较肝动脉介入栓塞化疗(TACE)联合伽玛刀治疗与TACE联合三维适形放射治疗原发性肝癌(HCC)的疗效.方法 将50例不能手术的Ⅱa或Ⅱb期HCC患者根据患者意愿和适应证分为TACE+伽玛刀治疗组(A组)25例与TACE+三维适形放射治疗组(B组)25例,两组一般情况无统计学差异.A组先行TACE(40％碘化油+CPDD+5- FU+ EADM)治疗2～3次后,再进行体部伽玛刀放射治疗.B组先行2～3次TACE治疗后,再行加速器适形放射治疗.结果 治疗后3个月评价疗效,A组RR率(CR+PR)为84％(21/25),1、2、3年生存率分别为76％,45.9％,20.44％.B组的RR率为56％ (14/25),与A组比较差异有统计学意义(P＜0.05),B组1、2、3年生存率分别为79.6％,30.2％,12.6％,与A组比较差异无统计学意义(P＞0.05).结论 与TACE联合适形放射治疗相比,TACE联合伽玛刀治疗HCC具有较高的近期有效率,而两种治疗的1、2、3年生存期差异无统计学意义.
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