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目的探讨肝动脉介入化疗栓塞(TACE)联合体部γ刀治疗原发性肝癌的治疗效果。方法选择2006年10月—2011年10月收治的原发性肝癌患者195例。83例行肝动脉介入化疗栓塞联合体部γ刀治疗(立体定向放射治疗);112例单纯行体部γ刀治疗;二组处方等剂量线均采用50%~65%等剂量包绕计划靶区;靶周单次剂量2.8~4Gy/次,治疗次数为8~12次,总靶周放射剂量33.6~44Gy。结果治疗后3个月观察组总有效率为90.3%,对照组总有效率为73.2%,二组总有效率比较差异有统计学意义(P<0.05);对照组患者的1、2、5年生存率分别为66.9%、47.3%,18.0%,平均生存为(18.1±2.5)个月。观察组患者的1、2、5年生存率分别为48.1%、32.5%,3.6%,平均生存期为(15.6±2.3)个月。二组生存率及平均生存期比较差异有统计学意义(P<0.05)。随访期内未见严重放射性并发症。结论体部γ刀配合介入化疗栓塞治疗原发性肝癌,操作简单,无创伤,副作用较轻,并发症少。能起到一个很好的协同作用,并且效果明显,值得推荐。
Objective To investigate the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with gamma knife on primary liver cancer. Methods Select 195 patients with primary liver cancer admitted from October 2006 to October 2011. 83 patients underwent hepatic arterial chemoembolization combined with gamma knife treatment (stereotactic radiotherapy); 112 patients were treated with gamma knife only; the other two groups of prescription dose lines were wound with 50% to 65% Area; the target single dose of 2.8 ~ 4Gy / time, the number of treatment was 8 to 12 times, the total target radiation dose 33.6 ~ 44Gy. Results The total effective rate was 90.3% in the observation group and 73.2% in the control group at 3 months after treatment. The total effective rate in the two groups was statistically significant (P <0.05). In the control group, 1,2,5 The annual survival rates were 66.9%, 47.3% and 18.0%, respectively. The average survival rate was (18.1 ± 2.5) months. The 1-, 2- and 5-year survival rates of the observation group were 48.1%, 32.5% and 3.6%, respectively. The mean survival time was (15.6 ± 2.3) months. The survival rate and mean survival time of two groups were statistically significant difference (P <0.05). No serious radioactive complications were observed during the follow-up period. Conclusion Gamma knife combined with chemoembolization in the treatment of primary liver cancer has the advantages of simple operation, no trauma, less side effects and fewer complications. Can play a very good synergy, and the effect is obvious, it is recommended.