目的：探讨立体定向体部放射治疗(SBRT)联合肝动脉介入栓塞化疗(TACE)治疗不能手术的原发性肝癌伴门静脉癌栓的临床疗效。方法：2012年11月至2018年9月原发性肝癌伴门静脉癌栓患者62例均采用体部伽玛刀联合TACE治疗，TACE 1~2次，体部伽玛刀局部照射癌栓4~9 Gy/次，隔日治疗5~10次，总剂量35~54 Gy (中位38 Gy)。结果：全部患者均完成治疗。10例(16.1%)癌栓完全缓解，21例(33.9%)部分缓解，25例(40.3%)稳定，6例(9.7%)进展，总有效率(CR + PR + NC) 56例(90.3%)；1、2和3年生存率分别为30.6%、16.1%和3.2%，中位生存期12.8个月。结论：SBRT联合TACE治疗原发性肝癌伴门静脉癌栓有效提高了患者生存质量，延长了生存期。
Objective: To investigate the clinical effect of body gamma knife combined with hepatic arterial chemoembolization (TACE) in the treatment of primary hepatic carcinoma with portal vein tumor thrombus. Methods: From November 2012 to September 2018, 62 patients with primary liver cancer and portal vein tumor Thrombi were treated with body gamma knife combined with TACE, TACE 1~2 times, body gamma knife local irradiation 4~9 Gy per time, and the total dose was 35~54 Gy (median dose was 38 Gy). Results: All patients completed the treatment course. 10 patients (16.1%) tumor thrombus was completely relieved, 21 patients (33.9%) had partial remission, 25 cases (40.3%) were stable, 6 cases (9.7%) increased, and the total effective rate (CR + PR + NC) was 56 (90.3%); 1, 2 and 3 year survival rates were 30.6%, 3.2% and 16.1%, respectively, and the median survival was 12.8 months. Conclusion: SBRT combined with TACE in the treatment of primary liver cancer with portal vein tumor thrombus can effectively improve the quality of life and prolong the survival time of patients.
