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《中国工程科学》 >> 2009年 第11卷 第10期

原发性肝癌三维适形和调强放疗的基础和临床研究

复旦大学附属肿瘤医院放射治疗科,上海 200032

收稿日期 :2009-08-12 发布日期 :2009-10-12 14:00:18.000

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摘要

报告三维适形(3-dimensional conformal radiation therapy, 3DCRT)和调强放疗(intensity-modulated radiation therapy, IMRT)治疗原发性肝癌(HCC)的基础和临床研究,建立了3DCRT和IMRT放疗HCC的技术,进行3个临床试验,获得了令人鼓舞的3年总生存率:28 %~33 %。治疗并发症主要是放射性肝病(RILD),此并发症的死亡率为76 %,预防RILD最有效的方法是把对正常肝脏的放射剂量限制在安全的范围内。我国的HCC病人大都伴有肝硬化,伴发的肝硬化损害了肝脏对放射损伤的修复和肝脏再生的能力,他们的放射耐受剂量是(全肝平均剂量):Child-Pugh A病人23 Gy,Child-Pugh B病人6 Gy,这个耐受量显著低于目前国际上通用的30 Gy。研究建立了用于预测我国HCC病人放疗中发生RILD发生概率的Lyman数学模式,其参数明显不同于国外的模式,并将一整套适合我国国情的HCC放疗技术成功地进行了临床实践,证实了放疗可以作为不能手术肝癌的一种治疗选择。

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参考文献

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