原发性肝细胞癌伴门静脉癌栓患者接受立体定向放射治疗的疗效观察

发布时间：2018-01-04 19:10

本文关键词：原发性肝细胞癌伴门静脉癌栓患者接受立体定向放射治疗的疗效观察　出处：《传染病信息》2016年04期 　论文类型：期刊论文

【摘要】：目的评价原发性肝细胞癌伴门静脉癌栓患者接受立体定向放射治疗(射波刀)的疗效。方法收集我院2011年1月—2015年5月原发性肝细胞癌伴门静脉癌栓患者59例,均接受射波刀治疗。门静脉癌栓的大体肿瘤体积为24.6~1265.0 cm3,中位数399.0 cm3,单次分割剂量5~13 Gy/次(中位数10 Gy),照射次数4~8次(中位数6次),肿瘤剂量35~56 Gy(中位数49 Gy),每d或隔1~2 d照射1次。采用寿命表法进行生存分析,Cox回归模型分析生存相关的影响因素。结果 59例肝癌伴门静脉癌栓患者接受射波刀治疗,中位无疾病进展生存期为5.19个月,中位总生存期为11.84个月,疾病控制率为62.71%(37/59),治疗后1年、2年、3年的累积生存率分别为49.15%(29/59)、20.34%(12/59)、11.86%(7/59)。Cox回归分析显示:术前AFP水平、性别、年龄、病灶大小、肿瘤数目、肝功能Child-Pugh分级、腹水、癌栓类型及总剂量大小对患者生存期无明显影响。结论射波刀是肝癌伴门静脉癌栓患者较理想的治疗方法,可显著延长患者生存期。
[Abstract]:Objective to evaluate the application of stereotactic radiotherapy in patients with primary hepatocellular carcinoma with portal vein tumor thrombus. Methods 59 cases of primary hepatocellular carcinoma with portal vein tumor thrombus were collected from January 2011 to May 2015 in our hospital. The gross tumor volume of portal vein tumor thrombus was 24.60.1265.0 cm ~ (3), median 399.0 cm3. The single fractionation dose was 5 ~ 13 Gy / time (median 10 Gy / time), the radiation frequency was 4 ~ 8 times (median 6 times), and the tumor dose was 35 ~ 56 Gy (median 49 Gy). Survival analysis and Cox regression model were used to analyze the factors related to survival. Results 59 patients with hepatocellular carcinoma with portal vein tumor thrombus were treated with radiosurgery. The median progressive survival time was 5.19 months, the median total survival time was 11.84 months, and the disease control rate was 62.71% 37 / 59, one year and two years after treatment. The 3-year cumulative survival rate was 49.15 / 29 / 20.340.12 / 59 / 11. 86 / 59. Cox regression analysis showed preoperative AFP level. Sex, age, focus size, tumor number, Child-Pugh grade of liver function, ascites. Conclusion the type of tumor thrombus and the total dose have no significant effect on the survival time of the patients. Conclusion the radiofrequency knife is an ideal treatment for patients with hepatocellular carcinoma and portal vein tumor thrombus, and can prolong the survival time of the patients significantly.
【作者单位】：解放军第三0二医院肿瘤放射治疗中心;解放军第三0二医院肝胆外科一中心;
【分类号】：R735.7;R730.55
【正文快照】： 原发性肝细胞癌(hepatocellular carcinoma,HCC)伴门静脉癌栓(portal vein tumor thrombosis,PVTT)是临床上无法手术切除肿瘤的常见原因,治疗方法有限,预后欠佳,因此肝动脉化疗栓塞术(transcatheter hepatic arterial chemoembolization,TACE)成为多数临床医生的选择,但如果门

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