立体定向适形放疗在早期肝癌治疗中的应用

目的:探讨立体定向适形放疗对早期肝癌患者临床疗效的影响。方法:回顾性分析我院2008年5月~2011年5月收治的190例早期肝癌患者,按照其治疗方式分为放疗组(n=95)及化疗组(n=95),2组患者分别接受立体定向适形放疗及肝动脉化疗栓塞治疗,比较患者的临床疗效。结果:2组患者治疗前后WBC、RBC、PLT、TBIL、ALT、PT指标均未见明显变化(P0.05);2组患者治疗后AFP、TMD均显著降低,放疗组降低程度更为明显(P0.05);放疗组总有效率为69.48%,显著高于化疗组的43.16%(P0.05)。2组患者治疗期间均发生胃肠道反应等并发症,经对症处理后症状消失,均未见其他严重并发症发生;2组患者1年复发率、1年生存率及2年生存率无明显统计学差异(P0.05);放疗组2年、3年复发率显著低于对照组,其3年生存率显著高于化疗组(P0.05)。结论:立体定向适形放疗能够有效降低早期肝癌患者AFP水平,缩小其肿瘤直径,具有良好的临床疗效,且该方案对患者血液指标、机体状态影响较小,具有良好的安全性,是保障医疗质量、改善患者预后的有效手段。

Stereotactic Conformal Radiotherapy in the Treatment of Early Hepatocellular Carcinoma

Objective:To investigate the effect and clinical outcomes of stereotactic conformal radiotherapy on early hepatocellular carcinoma.Methods:A retrospective analysis was performed for 190 cases of early HCC patients in our hospital fromMay 2008 to May 2011. The patients were randomly divided into radiotherapy group (n=95) and chemotherapy group (n=95), who were respectively treated with stereotactic conformal radiotherapy and chemotherapy of hepatic artery embolization. The clinical efficacy was compared between two groups.Results:There was no significant change before and after treatment in both two groups in the index of WBC, RBC, PLT, TBIL, ALT, PT index (P>0.05); the level of AFP and TMD was significantly decreased in both two groups, and it was more obviously in the radiotherapy group (P<0.05); the total effective rate of radiotherapy group was 69.48%, which was significantly higher than that of 43.16% in the chemotherapy group (P<0.05). During the treatment, the complications including neutropenia, gastrointestinal reaction were detected in both of two groups and after symptomatic treatment, the symptoms disappeared, and no other serious complications occurred. There was no significant difference between the two groups in the relapse rate at 1 year and 2 years survival rate (P>0.05), while the 2 years and 3 years recurrence rate was significantly lower in the radiotherapy group than in control group and the 3 years survival rate was significantly higher in the radiotherapy group than in chemotherapy group (P<0.05).Conclusion:The stereotactic conformal radiotherapy can effectively decrease the AFP level in patients with early hepatocellular carcinoma, reduce the tumor diameter. What''s more, it has only slight influence on the blood parameters of patients which indicates that stereotactic conformal radiotherapy has a good clinical efficacy with a high safety, and can contribute to improving the prognosis of patients of liver cancer.