TACE联合放射性125I粒子植入治疗不宜消融肝癌的安全性及有效性分析

目的 评价TACE联合¹²⁵I粒子植入治疗不宜消融肝癌的疗效。方法 将82例不宜消融的肝癌患者分为2组：联合组40例，予TACE联合¹²⁵I粒子植入治疗；对照组42例，予单纯TACE治疗。比较2组治疗后肝功能、血常规、血清甲胎蛋白（AFP）、并发症、客观有效率及远期生存率。结果 联合组¹²⁵I粒子植入术前、术后剂量学差异均无统计学意义（P均>0.05）。联合组术后3、6个月客观有效率85.00%（34/40）、67.50%（27/40）]明显高于对照组61.90%（26/42）、45.24%（19/42）；P均<0.05]。联合组患者中位生存时间为25.7个月，对照组为10.7个月；联合组1、2、3年累积生存率分别为77.50%、54.30%、23.30%，对照组为45.20%、32.60%、13.60%。联合组术后3个月及6个月血清AFP水平明显低于对照组（P均<0.05）。联合组治疗后1个月肝功能及血常规与术前差异均无统计学意义（P均>0.05）。结论 TACE联合¹²⁵I治疗不宜消融肝癌安全、有效。

Safety and efficacy of TACE combined with radioactive 125I seed implantation in treatment of hepatocellularcarcinoma of not good indication for ablation

Objective To investigate the efficacy and safety of TACE combined with ¹²⁵I seed implantation in the treatment of liver cancer of not good indication for ablation.Methods Eighty-two patients with liver cancer of not good indication for ablation were retrospectively analyzed. The patients were divided into two groups, 40 in combined group received TACE combined with CT-guided ¹²⁵I seed implantation and 42 in control group underwent TACE alone. Hepatic function, blood routine, serum alpha-fetoprotein (AFP) level, complications, local efficiency and the long-term survival rates after treatment were compared between groups.Results There was no significant difference of dosimetry pre- and post- ¹²⁵I implantation (all P>0.05). The objective effective rate of combined group (85.00%34/40], 67.50%27/40]) 3, 6 months after operation was significantly higher than those of control group (61.90%26/42], 45.24%19/42]; both P<0.05). The median survival time was 25.7 months of combined group and 10.7 months of control group. The 1-year, 2-year and 3-year cumulative survival rates of combined group were 77.50%, 54.30% and 23.30%, respectively, while of control group were 45.20%, 32.60% and 13.60%, respectively. AFP in combined group 3 months and 6 months after operation were significantly higher than in control group (both P<0.05). There was no significant difference of hepatic function preoperative and 1 month postoperative, nor of blood routine in combined group (both P>0.05).Conclusion TACE combined ¹²⁵I seed implantation is safe and effective in the treatment of liver cancer of not good indication for ablation.