目的:探讨经导管肝动脉灌注化疗栓塞(TACE)与TACE联合三维适形放射治疗(TACE + 3DCRT)原发性肝细胞癌(HCC)的疗效.方法:随机分成两组的HCC患者,均不能手术、门脉无癌栓、无远处脏器转移。50例患者行单纯TACE 2次(TACE组)。40例患者在TACE 2次后第四周再行三维适形放射治疗(TACE + 3DCRT组),放疗采用6MVX射线,4～6 Gy/次,隔日一次,3次/周,总剂量45～60 Gy。TACE采用碘化油、顺铂、5氟尿嘧啶、表阿霉素及明胶海绵。结果:TACE组与TACE+3DCRT组近期疗效有效率(完全缓解+部分缓解)分别为68.0%(34/50)、87.5%(35/40),1年生存率分别为78.0%(39/50)、95.0%(38/40),两组差异均有统计学意义(Plt;0.05)。TACE的治疗反应主要为栓塞综合征,3DCRT有7.5%(3/40)发生急性放射性肝炎,经对症、保肝处理后缓解。两组患者均能耐受。结论:TACE + 3DCRT治疗不能手术、门脉无癌栓、无远处脏器转移的HCC的疗效较单纯TACE治疗HCC的疗效好。
【摘要】 目的 探讨后程适形放射治疗（3 dimensional comformal radiation therapy，3D-CRT）同步化学疗法治疗Ⅲ期非小细胞肺癌（non-small-cell lung cancer，NSCLC）的近期疗效。 方法 搜集2005年1月-2008年6月NSCLC患者共115例，其中53例行单纯后程3D-CRT（单放组），62例行后程3D-CRT联合同步化学疗法（联合组），所有患者均经病理证实为Ⅲ期NSCLC。两组放射治疗方案均采用常规分割治疗加后程3D-CRT，DT 62～72 Gy。联合组化学疗法采用TP（紫杉醇 + 顺铂）方案。 结果 单放组和联合组近期疗效（完全缓解+部分缓解）分别为75.47%、91.94%，差异有统计学意义（Plt;0.05）。单放组和联合组的治疗不良反应主要有白细胞、血小板减少，放射性食管炎，放射性气管炎，恶心、呕吐等胃肠道反应。骨髓抑制和消化道反应，联合组稍高于单放组。经对症治疗后，所有患者均可耐受。 结论 后程3D-CRT联合TP方案化学疗法较单纯后程适形放射治疗明显提高Ⅲ期NSCLC近期疗效。患者耐受性尚可。【Abstract】 Objective To observe the recent therapeutic effect of late course 3 dimensional conformal therapy concomitant with chemotherapy on locally advanced stage Ⅲ non-small-cell lung cancer (NSCLC). Methods From January 2005 to June 2008, 115 patients with stage Ⅲ NSCLC were confirmed by pathology, in whom 53 only underwent late course conformal therapy (radiotherapy group), and another 62 underwent late course conformal therapy concomitant with chemotherapy (combined group). The radiotherapy schema of the two groups was routine division plus late course conformal therapy (with DT 62-72 Gy). The chemotherapy schema in the combined group was performed with TP (paclitaxel and DDP). Results The recent curative effect (complete remission plus partial remission) in radiotherapy group and combined group was 75.47% and 91.94%, respectively (Plt;0.05). The frequent adverse reactions in the two groups included leucocytopenia, thrombocytopenia, radioactive esophagitis, radioactive tracheitis, nauseated, and emesia. The rate of bone marrow depression and alimentary canal reaction in combined group was higher than that in the radiotherapy group. In the two groups, all patients could tolerance the treatments. Conclusion Late course 3 dimensional conformal therapy concomitant with TP schema chemotherapy for NSCLC could raise the recent curative effect. The patients could tolerance the treatments.