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中国癌症防治杂志

中国癌症防治杂志

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原发性肝癌合并脾功能亢进适形放疗33例临床分析

张忠新;贾伟丽;宫帅;   

  1. 青岛市市立医院肿瘤科;
  • 收稿日期:2010-03-25 修回日期:2010-03-25 出版日期:2010-03-25 发布日期:2010-03-25

Three dimensional conformal radiotherapy (3DCRT) on 33 cases of primary liver cancer combined hypersplenism

ZHANG Zhong-xin,JIA Wei-li,GONG Shuai.   

  1. (Department of Oncology,Qingdao Municipal Hospital,Shandong 266011,China
  • Received:2010-03-25 Revised:2010-03-25 Online:2010-03-25 Published:2010-03-25

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被引次数

12

摘要： 目的评价原发性肝癌合并脾亢适形放疗的疗效及其临床意义。方法对我院符合诊断标准的63例原发性肝癌伴门脉高压及脾亢患者,随机分为适形放疗组和药物治疗组。治疗组采用三维适形放疗,DT30Gy/15f,常规分割。对照组口服益血生治疗3周。检查两组治疗前后血常规,于放疗前后及口服益血生前后B超检查测量脾脏的大小,比较两组治疗前后血常规及脾脏的变化。结果放疗组放疗前WBC(2.5±0.1)×109/L,RBC(3.73±1.12)×1012/L,HGB(104±6)g/L,PLT为(45±4)×109/L;放疗后WBC(4.2±0.8)×109/L,RBC(3.66±2.21)×1012/L,HGB(100±3)g/L,PLT(96±5)×109/L。放疗前后WBC、PLT比较差异有统计学意义(P<0.05)。药物治疗组:口服益血生治疗前WBC、RBC、HGB、PLT分别为(2.5±1.2)×109/L、(3.55±6.2)×1012/L、(100±4)g/L、(48±4)×109/L;治疗后分别为(2.8±0.8)×109/L、(3.86±8.6)×1012/L、(103±5)g/L、(54±2)×109/L。四者治疗前后比较,差异均无统计学意义(P>0.05)。放疗后脾体积明显较放疗前缩小(P<0.05),而口服益血生前后脾体积无明显变化(P>0.05)。结论适行放疗可治疗原发性肝癌合并脾亢引起的白细胞和血小板减少,疗效确切,与手术和介入治疗相比,副反应小,是一种安全、有效的方法,值得临床推广应用。

关键词: 原发性肝癌, 脾亢, 适形治疗

Abstract: Objective To evaluate the therapeutic effect and clinical significance of three dimensional conformal radiotherapy(3DCRT) on primary liver cancer combined hypersplenism.Methods 63 cases of primary liver cancer combined hypersplenism were randomly distributed to 3DCRT group and control group.The patients in 3DCRT group were treated with DT30Gy/15f,conventional fractionated.The patients in control group were treated by Yixuesheng orally for three weeks.Routine blood test and spleen size check were taken before and after the treatment.Results Among the values of WBC,RBC,HGB and PLT,3DCRT group showed significant differences in RBC and PLT before and after radiotherapy(P<0.05).There was no significant difference in control group before and after drug treatment(P>0.05).Conclusions Hypoleukemia and thrombocytopenia induced by primary liver cancer combined hypersplenism can be treated by 3DCRT.Comparing to surgical and interventional treatments,the adverse reaction of 3DCRT is little and the therapeutic effect is exact.3DCRT is a safe and effective treatment which is worth applying in clinic.

Key words: Primary liver cancer, Hypersplenism, Three dimensional conformal radiotherapy(3DCRT)