TACE与γ刀治疗原发性肝癌时序探讨

目的：探讨经肝动脉插管化疗栓塞术（ TACE）和γ射线立体定向放射（γ刀）在不同时序上介入对原发性肝癌的疗效。方法：将53例原发性肝癌患者分为A、B两组，A组先行TACE后行γ刀治疗，B组先行γ刀后行TACE治疗，对照分析两组在疗效、生存期、复发时间、不良反应等方面的差异。结果：两组有效率分别为77.4％和77.3％，随访6、12、18个月，生存率分别为96.8％、80.6％、77.4％和63.6％、45.5％、18.2％。复发率分别为0％、16.1％、35.5％和18.2％、40.9％、77.3％。不良反应相似。结论：两组在有效率方面无差异，但在生存期和复发时间方面A组明显优于B组，而不良反应相似，表明不同方法在不同时序上介入对原发性肝癌治疗结果有直接影响。

Effect of timing of transcatheter arterial chemoembolization with gamma ray stereotactic radiotherapy for primary liver cancer

Objective：To investigate the difference in the efficacy of transcatheter arterial chemoembolization（ TA-CE）and gamma ray stereotactic radiotherapy（γknives）in different timing for primary liver cancer. Methods：All 53 patients with primary liver cancer were divided into two groups,patients in group A was treated with TACE and then with gamma knife,patients in group B was treated with gamma knife and then with TACE. To compare the efficacy, survival,recurrence time,adverse reaction between the two groups. Results：The efficacy were 77. 4% and 77. 3% in two groups,and after 6,12,and 18 months of follow-up,survival rates were 96. 8%,80. 6%,77. 4% and 63. 6%, 45. 5%,18. 2%,and recurrence rates were 0%,16. 1%,35. 5% and 18. 2%,40. 9%,77. 3%,and had similar ad-verse reactions. Conclusion：The treatment in two groups had no significant difference in efficacy,but the survival and recurrence time in group A was significantly better than group B,and had similar adverse reactions,indicated that the different timing of interventional treatment for primary liver cancer had directly impact on treatment outcomes.