适形调强放射治疗联合经动脉化疗栓塞治疗晚期肝细胞癌的预后研究
Prognostic study of IMRT combined with TACE for advanced hepatocellular carcinoma
王鸿飞 1杨柳 2周解平 2吴爱东3
作者信息
- 1. 安徽省肿瘤医院放疗科 合肥 230031;合肥工业大学汽车与交通工程学院 合肥 230031
- 2. 安徽省肿瘤医院放疗科 合肥 230031
- 3. 中国科学技术大学附属第一医院放疗科 合肥 230031
- 折叠
摘要
目的:探讨适形调强放射治疗(IMRT)联合经动脉化疗栓塞(TACE)治疗晚期肝细胞癌(HCC)的疗效及预后.方法:回顾性分析2015年12月至2021年12月安徽省肿瘤医院收治的114例晚期HCC患者,所有患者均采用IMRT联合TACE治疗,使用单因素及多因素Cox生存分析确定影响患者生存期的独立预测影响因素.结果:经IMRT联合TACE治疗后所有患者的总有效率(完全缓解+部分缓解)为60.5%(69/114).多因素分析发现肿瘤直径较大、高美国东部肿瘤协作组(ECOG)评分、Ⅲ～Ⅳ型门静脉癌栓(PVTT)、肝炎治疗和白细胞计数升高均是影响患者生存期的独立预测影响因素(HR=1.085、2.627、1.891、0.531、1.134,P＜0.05).结论:肿瘤Ⅲ～Ⅳ型PVTT和肿瘤直径较大对患者的生存有很大影响;而患者身体状态、肝炎治疗及全身炎症也是影响患者生存的重要因素.采用IMRT联合TACE治疗晚期HCC具有较好的治疗的效果,但应充分考虑预后生存影响因素.
Abstract
Objective:To investigate the curative effect and prognosis of intensity-modulated radiation therapy(IMRT)combined with transarterial chemoembolization(TACE)in treating advanced hepatocellular carcinoma(HCC).Methods:A retrospective analysis was conducted on 114 patients with advanced HCC who admitted to Anhui provincial cancer hospital from December 2015 to December 2021.All patients received IMRT combined with TACE.Univariate and multivariate COX survival analysis were performed to determine the independently predictive factors that affected survival period of patients.Results:The total effective rate(complete remission + partial remission)after IMRT combined with TACE was 60.5%(69/114)for all patients.Multivariate analysis revealed that larger tumor diameter,high score of Eastern Cooperative Oncology Group(ECOG),Ⅲ-Ⅳ portal vein tumor thrombosis(PVTT),hepatitis treatment status and elevated white blood cell count were independently predictive factors of affecting survival period of patients.Conclusion:The Ⅲ/Ⅳ PVTT of tumor and larger tumor diameter have significant influences on survival of patients,and other important factors that affect the survival of patients include physical condition of patients,hepatitis treatment and systemic inflammation.IMRT combined with TACE has better curative effect for advanced HCC,but the influence factors of prognostic survival should be fully considered.
关键词
肝细胞癌(HCC)/癌栓/经动脉化疗栓塞(TACE)/三维适形调强放射治疗(3D-IMRT)Key words
Hepatocellular carcinoma/Tumor thrombosis/Transarterial chemoembolization(TACE)/Three dimensional intensity-modulated radiation therapy(3D-IMRT)引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据