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[目的]探讨肝动脉化学栓塞(TACE)联合三维适形放射(3DCRT)治疗对中晚期原发性肝癌的疗效。[方法]19例中晚期原发性肝癌进行了TACE联合3DCRT治疗,TACE灌注化疗药物丝裂霉素C 20 mg,5-氟尿嘧啶1 000~1 500 mg,顺铂60~80 mg,栓塞剂为40%碘化油,治疗1~3次;3DCRT应用Topslane计划系统,6 MV-X直线加速器实施治疗,4~8个适形固定野,计划靶体积13.3~907 cm3,总剂量30~48 Gy,每次4~7 Gy,连续照射6~10次。[结果]近期有效率(CR+PR)73.7%,1、2年生存率分别为79%和42%,治疗前后不良反应无明显差异。[结论]TACE联合3DCRT能提高中晚期原发性肝癌的治疗效果,但不增加不良反应。
[Objective] To investigate the curative effect of transcatheter arterial chemoembolization (TACE) and three-dimensional conformal radiotherapy (3DCRT) on advanced primary liver cancer. [Method] TACE combined with 3DCRT was performed in 19 patients with advanced primary hepatocellular carcinoma. TACE chemotherapy with mitomycin C 20 mg, 5-fluorouracil 1000-1 500 mg and cisplatin 60-80 mg, 40% iodized oil for 1 to 3 times. 3DCRT was performed with Topslane planning system and 6 MV-X linear accelerator, and 4 to 8 conformal fixation fields with planned target volume of 13.3 to 907 cm3 and total dose of 30 to 48 Gy , Each 4 ~ 7 Gy, continuous irradiation 6 to 10 times. [Results] The recent effective rate (CR + PR) 73.7%, 1, 2-year survival rates were 79% and 42%, no significant difference in adverse reactions before and after treatment. [Conclusion] TACE combined with 3DCRT can improve the therapeutic effect of primary hepatocellular carcinoma in the advanced stage without increasing the adverse reaction.