肝动脉化疗TACE联合3DCRT治疗HCC伴PVTT患者的疗效

摘要

Objective To assess the therapeutic effectiveness of transarterial chemoembolization combined with three dimensional conformal radiotherapy for hepatocellular carcinoma with portal vein tumor thrombosis. Methods Retrospectively studied eighty HCC with PVTT patients whom were divided into two groups and stratified the PVTT into two types:in group A,patients were treated with only TACE;in group B were TACE combined with 3DCRT. The effectiveness and prognostic factors were evaluated. Results The effective rate of tumor and tumor thrombosis in group A were 52.5% and 55%,respectively. In group B were both 80%. There were significant difference between two groups(P<0.05). The median survival times of group A and B were 4.0 and 13.1 months,respectively(P<0.05). In the stratification of PVTT,the median survival time of patients in group B were significantly higher than group A on both type Ⅰ and Ⅱ(P<0.05). Multivariate analysis showed the tumor size,times of TACE and radiotherapy were significant prognostic factors for overall survival. Conclusions The combination of TACE and 3DCRT is effective for HCC patients with different type of PVTT.%目的：分析肝动脉化疗栓塞（TACE）联合三维适形放射（3DCRT）治疗原发性肝癌（HCC）伴门静脉癌栓（PVTT）的临床疗效。方法回顾性分析80例HCC伴PVTT患者，平均分为两组：A组单纯行TACE，B组行TACE联合3DCRT，同时进一步将癌栓分层，比较两组疗效和影响预后的因素。结果 A组的肿瘤有效率和癌栓有效率分别为52.5%和55%，B组的肿瘤有效率和癌栓有效率均为80%，差异有统计学意义（P<0.05）。A、B两组的中位生存期分别为：4.0和13.1个月（P<0.05），在癌栓分层中：B组的Ⅰ型、Ⅱ型中位生存期均明显高于A组（P<0.05），多因素分析显示肿瘤直径、TACE次数和放疗是患者重要的预后影响因素。结论 TACE联合3DCRT治疗HCC伴不同类型的PVTT有效。