中晚期肝癌患者49例临床治疗方法探讨

为了探讨中晚期肝癌的临床治疗价值，将49例不能接受手术的中晚期肝癌患者分3组采用不同的方法治疗。18例接受单纯放射治疗（RT）；18例接受单纯的肝动脉导管化疗栓塞（TACE）；13例采用肝动脉导管化疗栓塞加放疗（TACE＋RT）。结果49例患者的1、2、3年生存率分别为61.2％、32．6％和14．3％，各组1、2、3年生存率分别为TACE组38．9％、5．6％和0，RT组66．7％、38．9％和16．7％，TACE＋RT组84．6％、53．8％和30．8％。TACE组与RT组之间及TACE＋RT组与RT组之间差异均无统计学意义，P均〉0．05；TACE＋RT组与TACE组之间差异有统计学意义，P〈0．05。初步研究结果提示，中晚期肝癌在临床治疗上TACE＋RT的疗效优于单纯RT及单纯TACE，由此对失去手术机会的中晚期肝癌仍可积极治疗，TACE＋RT联合治疗为首选治疗。

Study on the value of clinical treatment for 49 middle or advanced stage hepatocellular carcinoma

The objective of this research was to study the value of clinical treatment for 49 cases of unable-surgery middle or advanced stage hepatocellular carcinoma. With different treatment methods after divided into 3 groups, 18 patients were treated with radiation therapy (RT) only; 18 with transhepatic arterial chemoembolization (TACE); 13 with TACE+RT. A total of 49 cases showed the survival rates of 1-,2-,3- year were 61.2%, 32.6% and 14.3%, respectively; 1-,2-,3-,year survival rates were 38.9%, 5.6%, 0, in TACE group; 66.7%, 38.9%, 16.7%, in RT group; 84.6%, 53.8%, 30.8% in TACE + RT group. There was no significant statistic difference between groups of TACE and RT, neither between groups of TACE+ RT and RT, P>0.05; but there was a significant statistic difference between groups TACE+RT and TACE, P<0.05. Primary study indicates that TACE+RT has better therapeutic results than RT or TACE used only in middle or advanced stage hepatocellular carcinoma. TACE+RT combined therapy is more effective, and to is the first selection, than other methods for unable-surgery middle or advanced stage hepatocellular carcinoma.