| 灌注式热化疗联合微球在原发性肝癌介入治疗中的价值 |
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| 引用本文： | 刘亚,曾建挺,张艳林,梁长宇,王春梅,张斌.灌注式热化疗联合微球在原发性肝癌介入治疗中的价值[J].中国医学物理学杂志,2018,0(11):1339-1344. |
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| 作者姓名： | 刘亚 曾建挺 张艳林 梁长宇 王春梅 张斌 |
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| 作者单位： | 重庆大学附属肿瘤医院医学影像科， 重庆 400030 |
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| 摘 要： | 目的:观察灌注式热化疗联合微球在原发性肝癌经导管肝动脉化学栓塞（TACE）治疗中的应用价值。 方法:采用便利抽样法选取90例原发性肝癌患者为对象，按照随机数表法分为两组，各45例，其中观察组以化疗药物＋65°热碘油＋微球序贯行TACE治疗，对照组以化疗药物＋常温碘油化疗药乳化合剂＋微球序贯行TACE治疗，术中均灌注化疗替加氟750 mg/m2＋奥沙利铂60 mg/m2。以每4周为1周期，均予以2~6个周期的化疗灌注栓塞治疗。对比两组近期疗效，观察治疗前及治疗4周时血液指标变化情况，包括甲胎蛋白（AFP）及肝肾功能指标丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、尿素氮（BUN）、肌酐（CREA）、白蛋白（ALB）、总胆红素（TBIL），并分析毒副反应发生率及远期随访结果。 结果:观察组总缓解率ORR为84.44%、对照组为64.44%，差异有统计学意义（P<0.05）。两组治疗4周后，观察组AFP水平显著低于治疗前（P<0.05），ALT、AST、BUN、CREA水平较治疗前无统计学意义（P>0.05），对照组上述指标较治疗前均无统计学意义（P>0.05）；观察组治疗4周后AFP水平显著低于对照组（P<0.05），其他指标较对照组无统计学意义（P>0.05）。观察组毒副反应发生率为22.22%、2年远期生存率为88.89%；对照组依次为20.00%、71.11%，2年远期生存率差异有统计学意义（P<0.05）。 结论:以灌注式热化疗联合微球对原发性肝癌患者行TACE术治疗，近远期疗效显著，毒副反应发生率低。
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| 关 键 词： | 原发性肝癌 灌注式热化疗 微球 介入治疗 |
Value of perfusion thermo-chemotherapy combined with microspheres in the interventional treatment of primary liver cancer |
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| LIU Ya,ZENG Jianting,ZHANG Yanlin,LIANG Changyu,WANG Chunmei,ZHANG Bin. Value of perfusion thermo-chemotherapy combined with microspheres in the interventional treatment of primary liver cancer[J].Chinese Journal of Medical Physics,2018,0(11):1339-1344. |
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| Authors: | LIU Ya ZENG Jianting ZHANG Yanlin LIANG Changyu WANG Chunmei ZHANG Bin |
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| Affiliation: | Department of Medical Imaging, Chongqing Cancer Hospital, Chongqing University, Chongqing 400030, China |
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| Abstract: | Abstract: Objective To investigate the value of perfusion thermo-chemotherapy combined with microspheres in the transcatheter arterial chemoembolization (TACE) for primary liver cancer. Methods A total of 90 patients with primary liver cancer were selected and randomly divided into observation group and control group, with 45 cases in each group. The patients in observation group were treated with chemotherapy + lipiodol of 65° + microspheres sequential treatment combined with TACE, while those in control group were treated with chemotherapy + lipiodol at room temperature combined with emulsifier + microspheres sequential treatment combined with TACE. During the operation, two groups of patients received the chemotherapy with tegafur of 750 mg/m2 and oxaliplatin of 60 mg/m2 once every 4 weeks. A total of 2-6 cycles of chemotherapy were given. The short-term therapeutic effects were compared between two groups. Moreover, the changes of blood indexes before treatment and after 4 weeks of treatment were also compared. The blood indexes discussed in this research included alpha fetoprotein (AFP) and several liver and kidney function indexes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), creatinine (CREA), albumin (ALB) and total bilirubin (TBIL). The incidence of toxic and adverse reactions and long-term follow-up results were also analyzed. Results The overall response rate was 84.44% in observation group and 64.44% in control group, with statistical differences (P<0.05). After 4 weeks of treatment, the AFP level in observation group was significantly lower than that before treatment (P<0.05), and no significant differences were found in the level of ALT, AST, BUN and CREA (P>0.05). In control group, there were no significant differences in above-mentioned indexes before and after treatment (P>0.05). After 4 weeks of treatment, no statistical significance was found in the indexes between two groups (P>0.05), except the AFP level which was significantly lower in observation group (P<0.05). The incidence of toxic and adverse reactions was 22.22% in observation group and 20.00% in control group, without statistical difference (P>0.05). The 2-year survival rate in observation group was significantly higher than that in control group (88.89% vs 71.11%, P<0.05). Conclusion Applying perfusion hyperthermic chemotherapy combined with microspheres for TACE in patients with primary liver cancer achieves remarkable short- and long-term therapeutic effects and has a low incidence of toxic and adverse reactions. |
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| Keywords: | Keywords: primary liver cancer perfusion thermo-chemotherapy microspheres interventional therapy |
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