经动脉化疗栓塞联合调强放疗治疗中晚期肝癌的疗效观察

IF 2.5 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES

Journal of Radiation Research and Applied Sciences Pub Date : 2025-09-08 DOI:10.1016/j.jrras.2025.101908

Cong Zhang , Xiaoli Zhu

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引用次数: 0

摘要

背景：肝细胞癌是一种常见的恶性肿瘤，治疗方案有限，尤其是中晚期患者。经动脉化疗栓塞（TACE）和调强放疗（IMRT）是治疗肝癌的重要方法，但其联合疗效尚未得到充分评价。本研究旨在探讨TACE联合IMRT治疗中晚期肝癌患者的疗效。方法本研究纳入170例肝癌患者，其中85例接受TACE治疗（对照组），85例接受TACE联合IMRT治疗（观察组）。评价两种治疗方法对肿瘤反应及肝功能指标的影响。采用多元logistic回归分析评价干预方式与其他因素对患者生存状况的影响，采用Andersson模型分析干预方式与其他因素的交互作用。结果治疗后，观察组患者的完全缓解率、部分缓解率、病情稳定进展率均显著高于对照组。治疗后2、4、6个月，观察组患者总胆红素、白蛋白、凝血酶原时间、甲胎蛋白水平均显著优于对照组（P值<； 0.05）。观察组不良事件发生率高于对照组，但差异无统计学意义。生存分析显示，观察组患者的生存率和无进展生存率均显著高于对照组。干预方式、年龄、肿瘤进展、Child Pugh评分均对患者生存状态有显著影响。干预方法、肿瘤进展和Child Pugh评分之间存在拮抗作用。结论tace联合IMRT治疗肝癌疗效好，可改善肝功能，显著提高患者生存率，安全性高。干预方法、肿瘤进展和肝功能评分之间的相互作用对生存状态有显著影响。联合治疗是治疗肝细胞癌的有效方法。

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The efficacy of transarterial chemoembolization combined with intensity-modulated radiation therapy in the treatment of intermediate and advanced hepatocellular carcinoma

Background

Hepatocellular carcinoma is a common malignant tumor with limited treatment options, especially for patients in the middle and late stages. Transarterial chemoembolization (TACE) and intensity-modulated radiation therapy (IMRT) are important methods for treating hepatocellular carcinoma, but their combined efficacy has not been fully evaluated. The aim of this study is to investigate the efficacy of TACE combined with IMRT in patients with intermediate and advanced hepatocellular carcinoma.

Method

This study included 170 hepatocellular carcinoma patients, of whom 85 received TACE treatment (control group) and 85 received TACE combined with IMRT treatment (observation group). Evaluate the impact of two treatment methods on tumor response and liver function indicators. Use multiple logistic regression analysis to evaluate the impact of intervention methods and other factors on patient survival status, and use the Andersson model to analyze the interaction between intervention methods and other factors.

Result

After treatment, the observation group showed significantly higher rates of complete remission, partial remission, and stable progressive disease compared to the control group. The total bilirubin, albumin, prothrombin time, and alpha fetoprotein levels in the observation group were significantly better than those in the control group at 2, 4, and 6 months after treatment (P values < 0.05). The incidence of adverse events in the observation group increased compared to the control group, but the difference was not statistically significant. Survival analysis showed that the survival rate and progression free survival rate of the observation group were significantly higher than those of the control group. Intervention methods, age, tumor progression, and Child Pugh score all have a significant impact on the survival status of patients. There is an antagonistic effect between intervention methods, tumor progression, and Child Pugh score.

Conclusion

TACE combined with IMRT has a good therapeutic effect on hepatocellular carcinoma, which can improve liver function and significantly improve patient survival rate with high safety. The interaction between intervention methods, tumor progression, and liver function scores has a significant impact on survival status. Combination therapy can be an effective treatment for hepatocellular carcinoma.

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来源期刊

Journal of Radiation Research and Applied Sciences MULTIDISCIPLINARY SCIENCES-

自引率

5.90%

发文量

130

审稿时长

16 weeks

期刊介绍： Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.