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中国癌症防治杂志

中国癌症防治杂志 ›› 2012, Vol. 4 ›› Issue (2): 158-162.doi: 10.3969/j.issn.1674-5671.2012.02.15

• 肝癌专栏 • 上一篇    下一篇

立体定向放射治疗联合中药治疗原发性大肝癌的临床研究

  

  1. 武警湖北省总队医院1伽玛刀中心；2影像科；3胸外科；4肿瘤科；5中医肿瘤科
  • 出版日期:2012-06-25 发布日期:2012-07-03
  • 通讯作者: 庞 军 E-mail:junp.tumor@163.com
  • 基金资助:

    武警湖北省总队后勤部湖北省总队医院科研项目（2011013）

Whole-body γ-knife radiotherapy combined with Chinese herbal drugs to treat large pri-mary liver cancer

  • Online:2012-06-25 Published:2012-07-03

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526

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被引次数

18

摘要： 目的 探讨全身γ刀立体定向放射治疗联合中药治疗原发性大肝癌的疗效及毒副反应。方法 将2009年7月至2011年2月我院收治的100例符合入选条件的原发性大肝癌患者随机分为治疗组（48例）和对照组（52例）。治疗组予体部伽玛刀加中药治疗。采用超级γ刀（SGS-I型）立体定向放射治疗，根据肿瘤的位置、临床靶体积和患者的身体状况与治疗目的,制定放射治疗计划及调整剂量分布。肿瘤体积55.9～2 579.0cm3，等剂量曲线50%～60%,周边照射总剂量33～40Gy，分割处方剂量3.3～5.0Gy，重复治疗8～12次，5次/周。中药治疗采用中药协定1号处方和2号处方加减，1号处方（党参、葛根、白术、黄芩等21味）用于伽玛刀治疗中和治疗后半月内，以健脾和胃、清热理气为主，辅以化瘀、补肾等；2号方（党参、葛根、白术、柴胡等21味）在伽玛刀治疗后半月开始，至少服用2～3月，以健脾和胃、疏肝理气为主，辅以化瘀、抗癌等。对照组予体部伽玛刀治疗，方法同前。结果 两组患者治疗后2～3个月行CT或MR复查, 肿瘤控制总有效率分别为95.83%和94.23%，6个月和1年生存率分别为75.00%、71.15%和60.42%、57.69%。差异均无统计学意义（P ＞0.05）。在提高患者生活质量、减轻临床症状和改善肝功能方面差异有统计学意义（P ＜0.05）。结论 全身γ刀立体定向放射治疗原发性大肝癌临床疗效确切，毒副反应较轻。联合中药治疗可以提高患者生活质量、减轻放疗不良反应。

关键词:  原发性大肝癌, 全身伽玛刀, 立体定向放射治疗, 中医药

Abstract: Objective To investigate the clinical application and short-term effects of stereotactic whole-body γ-knife radiotherapy combined with Chinese herbal drugs to treat patients with large primary liver cancer. Methods A total of 100 patients with large pri-mary liver cancer hospitalized from July 2009 to February 2011 were randomly divided into a treatment group and control group.The treatment group was treated with whole-body γ-knife radiotherapy combined with Chinese herbal drugs.Stereotactic super-γ-knife ra-diotherapy was carried out 4~12 times，5 times per week（tumor size，55.9~2579.0 cm3；isodose curve，50％~60%；total radiation dose， 33~40 Gy；fractional dose，3.3~5.0 Gy）.Treatment with Chinese herbal drugs（prescription No. 1）was carried out during radiotherapy or for 2~3 months after the radiotherapy.Prescription No.2 was used for 2~3 months after radiotherapy.The control group was treated with only stereotactic super-γ-knife radiotherapy.Therapeutic effects and side effects of the two treatments were analyzed. Results The overall response rates at 3 months after treatment were 95.83% in the treatment group and 94.23% in the control group.The treatment group showed 6-month and 1-year survival rates of 75.00% and 71.15%，compared to 60.42% and 57.69% for the control group.The two groups did not differ significantly in curative effects（P>0.05），whereas they did differ significantly in adverse reactions（P<0.05）. Conclusion Stereotactic super-γ-knife radiotherapy is effective for treating large primary liver cancer， and the combination of whole-body γ-knife with Chinese herbal drugs can improve quality of life significantly and reduce the adverse reactions due to radiotherapy.

Key words:  Large primary liver cancer, Whole-body γ-knife, Stereotactic radiotherapy, Chinese herbal drugs