Intra-arterial 5-fluorouracil/interferon combination therapy for advanced hepatocellular carcinoma with or without three-dimensional conformal radiotherapy for portal vein tumor thrombosis
Intra-arterial 5-fluorouracil/interferon combination therapy for advanced hepatocellular carcinoma with or without three-dimensional conformal radiotherapy for portal vein tumor thrombosis
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DOI：
10.1007/s00535-009-0033-y
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发表时间：
2009-05-01
影响因子：
6.3
通讯作者：
Chayama, Kazuaki
中科院分区：
文献类型：
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作者：
Katamura, Yoshio;Aikata, Hiroshi;Chayama, Kazuaki
为探讨5-氟尿嘧啶(5-FU)和干扰素(干扰素)联合三维适形放射治疗(3D-CRT)治疗门静脉癌栓(PVTT)的疗效，将16例肝细胞癌门静脉癌栓患者分为RT组(RT组)和对照组(非RT组)。RT组完全缓解(CR)3例(19%)，部分缓解(PR)9例(56%)，稳定期(SD)4例(25%)，进展(PR)0例，非RT组分别为1例(6%)、3例(19%)、7例(44%)和5例(31%)。放疗组的客观有效率高于单纯放疗组(P=0.012)。RT组胃底静脉曲张破裂、食道胃底静脉曲张恶化、出现无法控制的腹水的发生率低于非RT组(P=0.0195)。放疗组的中位生存时间(7.5个月)与非放疗组的中位生存期(7.9个月)无显著差异。5-FU/干扰素联合3D-CRT治疗PVTT可提高PVTT的应答率，降低门脉高压相关事件的发生率。
The aim of this study was to elucidate the efficacy of intra-arterial 5-fluorouracil (5-FU) and interferon (IFN) alpha combined with three-dimensional conformal radiotherapy (3D-CRT) for portal vein tumor thrombosis (PVTT).The study groups were 16 HCC patients with PVTT treated with 5-FU/IFN combined with 3D-CRT (RT group) and 16 matched controls treated with 5-FU/IFN alone (non-RT group). We compared the survival rate, response, time to progression (TTP), portal hypertension-related events (PREs) and safety.Complete response (CR) of PVTT, partial response (PR), stable disease (SD) and progressive disease (PR) were noted in three (19%), nine (56%), four (25%) and zero patients of the RT group, one (6%), three (19%), seven (44%) and five (31%) patients of the non-RT group, respectively. The objective response rate of PVTT was higher in the RT group (P = 0.012). The rate of PREs (variceal rupture, worsening of esophagogastric varices and emerging of uncontrollable ascites) was lower in the RT group than in the non-RT group (P = 0.0195). The median survival time of the RT group (7.5 months) was not significantly different from that of the non-RT group (7.9 months). RT-induced liver disease was not observed.5-FU/IFN combination with 3D-CRT for PVTT improved the response rate of PVTT and reduced the incidence of portal hypertension-related events.