综合序贯疗法治疗中晚期肝癌临床研究

目的：探讨肝动脉栓塞化疗术（ＴＯＣＥ另ＧＳ）、瘤内无水酒精注射术（ＰＥＩ）和门静脉介入治疗术（ＰＶＥ）即３介入治疗，联合特异性肿瘤细胞毒Ｔ淋巴细胞（ＣＴＬｓ）的综合序贯疗法在中晚期肝癌治疗中的优越性。方法：１２７例中晚期肝癌（Ⅱ～Ⅲ期，巨块型或结节型，肝功ＣｈｉｄｌＡ或Ｂ级）患者随机分Ａ、Ｂ、Ｃ３组。其中Ａ组５２例为治疗组，予综合序贯治疗，Ｂ组（４５例）、Ｃ组（３０例）为对照组，分别予ＴＯＣＥ、Ｇ

Clinical Study on Comprehensive and Sequential Therapy of Middle and Advanced Hepatocellular Carcinoma

Aim ;To study the value of the comprehensive therapy in the treatment of middle and advanced stage hep-atocellular carcinoma by three intervention therapies of Transcatheter Oily Chemoembolization Ge!foam (TOCE GF), Percutaneous Ethylalcohol Injection (PEI) and Portal Vein Embolization (PVE) combined with CTLs. Methods: 127 cases of middle and advanced stage hepatocellular carcinoma (periods I - I .massive type or nodular type)were randomly divided into A, B. C three groups of which 52 cases of group A were treated with comprehensive therapy, group B (45 cases) and group C (30 cases) were treated with TOCE GF combined with CTLs and pure TOCE GF, whose respective period of treatment was 2 to 4 months. Results: Respective rate of remission (%) of group A, B and C was 76. 9, 68-9, 46.7 (P<0. 05); 12-month and 24-month survival rates (%) were respectively 71.2, 60. 0, 43. 4 and 57. 7, 37. 8. 30. 0 (P<0. 05) ( respective median life (month) were 21. 19, 14- 81 and 9. 83 (P<0. 05) (For the functional alteration of peripheral blood T cell subgroup after treatment , existed significantly difference (P<0. 05) among groups A, B and Ci the AFP (ng/ml) levels existed significantly difference (P<0. 05) between groups A, B and C; after one year treatment, the respective extrahepatic transference rate (%) of group A, B and C 25- 0, 26. 7, 46. 7. In the course of treatment no significantly difference of Karnofsky grading variations could be found among the three groups. Conclusion: The comprehensive and sequential therapy ofthe three intervention therapies combined with specific tumour CTLs can increase the survival rate and extend the life of middle and advanced hepatocellular carcinoma for one or two years.