目的:探讨影响三维适形放疗(3-Dimensional conformal radiotherapy,3DCRT)治疗原发性肝癌的影响因素。方法:收集2008年1月到2010年12月间58例我院原发性肝癌病人,先通过CT扫描定位勾画靶区,经实时验证参数后实施适形放射治疗。观察疗效。并运用Cox回归模型对肿瘤大小、肿瘤分期、肝功能和甲胎蛋白(AFP)水平和照射剂量因素进行分析。结果:完全缓解(CR)13例,部分缓解(PR)35例,总有效(CR+PR)率为82.76%,1、2、3年生存率分别为69.5%、43.10%、27.57%。肿瘤大小、肿瘤分期、甲胎蛋白水平和照射剂量可影响3DCRT效果(P小于0.05),肝功能对3DCRT效果(P小于0.05)。结论:肿瘤分期、肝功能和甲胎蛋白(AFT)水平,分割方式、照射剂量和效应可影响三维适形放疗治疗原发性肝癌的效果。 Objective: To investigate the influencing factors of 3-Dimensional conformal radiotherapy (3DCRT) on primary hepatocellular carcinoma. Methods: From January 2008 to December 2010, 58 cases of primary hepatocellular carcinoma in our hospital were collected. The target was first sketched by CT scanning and conformal radiotherapy was performed after real-time verification of the parameters. Observe the effect. Cox regression model was used to analyze tumor size, tumor stage, liver function and AFP levels and dose factors. Results: Thirteen patients were completely relieved (CR) and 35 were partially relieved (PR). The total effective rate (CR + PR) was 82.76%. The 1-, 2-, and 3-year survival rates were 69.5%, 43.10% and 27.57%, respectively. The tumor size, tumor stage, alpha-fetoprotein level and irradiation dose could affect the 3DCRT effect (P less than 0.05) and the effect of liver function on 3DCRT (P less than 0.05). Conclusion: The tumor staging, hepatic function and AFP level, mode of division, dose and effect of irradiation may affect the efficacy of three-dimensional conformal radiotherapy in the treatment of primary liver cancer.