化疗联合全身热疗治疗中晚期卵巢癌疗效观察

目的：观察并评价TP化疗方案联合全身热疗对中晚期卵巢癌的治疗作用。方法：采用TP双途径化疗联合全身热疗治疗26例中晚期卵巢癌患者,观察近期疗效及毒副反应。结果：26例患者卡氏评分提高20—40分。CR21例,PR3例,SD1例,PD1例;有效率为92．3％。1年无瘤生存率为88．5％。结论：TP双途径化疗联合全身热疗治疗中晚期卵巢癌疗效肯定,毒副反应小,值得推广应用。     

全身热疗联合化疗对中晚期肺癌的疗效观察

目的观察全身热疗联合化疗对中晚期肺癌患者的近期疗效及安全性。方法回顾性分析中晚期肺癌患者128例,分为单纯化疗组（A组）和化疗联合全身热疗组（B组）,其中A组64例,给予多西他赛注射液75 mg/m2,d1,顺铂注射液30 mg/m2,d1～32,个周期;B组64例采用同样方案化疗,第1天同时给予深度镇静全身热疗,使全身温度升至40℃～42℃,维持90 min,2个周期;观察A组和B组患者的近期疗效及毒副作用。结果 A组中完全缓解（CR）0例,部分缓解（PR）33例,稳定（SD）17例,进展（PD）14例,有效率（CR＋PR）为51.6%;B组中CR 3例,PR 50例,SD 7例,PD 4例,CR＋PR为82.8%;两组比较,差异有统计学意义（P=0.01）。Ⅲ～Ⅳ度肝、肾功能损害、骨髓抑制及消化道反应发生率A组分别为7.8%、14.0%及20.3%;B组分别为10.9%、10.9%及23.4%,差异均无统计学意义（P=0.15）。结论全身热疗联合化疗治疗中晚期肺癌的疗效确切,毒副作用轻,耐受良好,值得临床推广。     

恩度结合局部热疗、肝动脉栓塞化疗治疗中晚期肝癌临床观察

目的 探讨恩度结合局部热疗、肝动脉栓塞化疗治疗中晚期肝癌的疗效.方法 治疗组:18例在肝动脉栓塞化疗治疗时联合局部热疗;对照组:恩度及20例采用肝动脉栓塞化疗,比较两组的临床疗效、疾病相关症状改善及毒副反应.结果 治疗组临床疗效及疾病相关症状改善明显好于对照组,毒刷反应无明显差别.结论 恩度结合局部热疗、肝动脉栓塞化疗治疗中晚期肝癌是有效的,值得临床推广及进一步研究.     

三维适形放疗联合肝动脉碘油栓塞化疗并热疗治疗原发性肝癌的疗效研究

目的：探讨原发性肝癌的肝动脉碘油栓塞化疗（TACE）、热疗、三维适形放疗（3DCRT）的综合治疗价值。方法：122例原发性肝癌患者进行前瞻性随机分组研究,综合治疗组64例,行TACE并3DCRT,结合热疗治疗。对照组58例3DCRT治疗,联合TACE。结果：1、2、3年生存率综合治疗组分别为85%、65%、39%,对照组分别为59%、30%、18%（P〈0.05）两组毒副作用相似。结论：对于非手术切除的原发性肝癌患者,TA-CE,结合3DCRT并热疗,能明显提高疗效,而毒副作用不增加。     

全身热疗联合化疗治疗晚期胃癌的疗效分析

目的：观察全身热疗联合DCF方案化疗治疗晚期胃癌的近期疗效及毒副反应。方法67例晚期胃癌患者随机分为治疗组（32例）和对照组（35例）,2组患者均采用DCF方案全身化疗,化疗第1天在全麻状态下用ET-SPACE全身热疗系统进行全身加热时开始静脉给药。结果治疗组总有效率和生活质量提高率均高于对照组（P均〈0.05）;2组毒副反应发生率比较差异无统计学意义（P均〉0.05）。结论全身热疗联合DCF方案化疗治疗晚期胃癌可以获得较好的近期疗效,改善患者的生活质量,且毒副反应未增加,值得临床进一步推广。     

热疗联合化疗治疗晚期原发性肝癌临床观察

原发性肝癌是我国常见的恶性肿瘤之一,恶性程度高,起病隐匿,复发率高,能够接受手术切除治疗的肝癌患者仅占20%左右[1]。故临床上大多数肝癌仍需采用非手术疗法。肝癌主要治疗手段有手术、放疗、化疗、介入治疗等。对于病变范围小、孤立、数目少的可以手术或放疗;对于病变大又有     

三维适形放疗联合肝动脉碘油栓塞化疗并热疗治疗原发性肝癌的疗效研究

目的:探讨原发性肝癌的肝动脉碘油栓塞化疗(TACE)、热疗、三维适形放疗(3DCRT)的综合治疗价值。方法:122例原发性肝癌患者进行前瞻性随机分组研究,综合治疗组64例,行TACE并3DCRT,结合热疗治疗。对照组58例3DCRT治疗,联合TACE。结果:1、2、3年生存率综合治疗组分别为85%、65%、39%,对照组分别为59%、30%、18%(P<0.05)两组毒副作用相似。结论:对于非手术切除的原发性肝癌患者,TA-CE,结合3DCRT并热疗,能明显提高疗效,而毒副作用不增加。     

全身热疗联合化疗治疗晚期恶性肿瘤-220例疗效分析

目的:观察晚期恶性肿瘤患者全身热疗联合化疗的近期疗效与毒副反应。方法:220例晚期恶性肿瘤患者,采用常规化疗联合全身热疗,观察其疗效。全身热疗采用SRI全身热疗系统,温度40℃±0.5℃,持续90-120分钟,1次/3周。结果:近期疗效,完全缓解(CR)3例(1.36%),部分缓解(PR)28例(12.73%),疾病稳定(SD)118例(53.64%),疾病进展(PD)71例(32.27%),疾病控制率(CR+PR+SD)67.73%。绝大多数患者自觉症状好转,生活质量提高。结论:全身热疗联合化疗近期疗效确切,不同肿瘤对全身热疗的敏感性还有待进一步研究证实。     

肝动脉热化疗栓塞治疗原发性肝癌疗效观察

目的:评价热化疗栓塞对原发性肝癌的中长期疗效。方法:回顾性分析1994年11月至2012年2月172例原发性肝癌行热化疗栓塞治疗患者的临床资料,应用Seldinger技术,经股动脉穿刺置管,通过肝动脉导管将微导管超选择置入肿瘤供血动脉,以碘油20ml与顺铂100mg或丝裂霉素8mg的110℃混悬液行热化疗栓塞。以门诊及电话方式随访收集资料。通过影像学检查观察肿瘤大小变化,用寿命表法计算患者累积生存率。结果:1-10年累积生存率分别为52.33%、34.88%、21.51%、12.21%、7.56％、1.74%、1.74％、1.16％、1.16%、1.16%。治疗前后有CT、B超或DSA等影像学资料对比的患者160例,完全缓解（CR） 2例（1.25%）,部分缓解（PR）49例（30.63%）,稳定（SD）78例（48.75%）,进展（PD）31例（19.38%）;有效率（CR＋PR）31.88％,肿瘤控制率（CR＋PR＋SD）80.63%。结论:热化疗栓塞是原发性肝癌的有效治疗手段。     

康莱特联合介入化疗栓塞治疗中晚期肝癌疗效观察

目的：探讨康莱特注射液（KLT）联合介入化疗栓塞（TACE）治疗中晚期肝癌的疗效。方法：分组比较单用介入化疗栓塞（对照组25例）与康莱特联合介入化疗栓塞（治疗组31例）对症状改善、血生化指标及近期疗效的差异。结果：在临床症状改善，抑制瘤体生长，减轻介入化疗后毒副作用方面，治疗组明显优于对照组。结论：康莱特联合介入化疗栓塞治疗中晚期肝癌能明显提高疗效。改善症状，降低介入化疗栓塞 的毒副作用。     

肝动脉化疗栓塞术治疗中晚期肝癌120例疗效分析

目的 观察经导管肝动脉化疗栓塞术(TACE)治疗中晚期原发性肝癌的疗效、毒副反应.方法 采用 Seldinger技术,经股动脉穿剌,选择性肝动脉插管灌注化疗药物联合碘油栓塞或加用明胶海绵治疗中晚期原发性肝癌患者120例,共行 280次介入治疗.结果 全组120例患者中,完全缓解60.0%(72/120),部分缓解31.7%(38/120),稳定8.3%(10 /120),12个月以上生存率达63.3%(76/120).结论 TACE治疗中晚期原发性肝癌疗效确切,能够显著延长患者的生存期,提高其生存质量.     

肝动脉化疗栓塞联合射频消融治疗中晚期肝癌的临床疗效

目的探讨肝动脉化疗栓塞（TACE）联合射频消融（RFA）治疗中晚期肝癌的临床疗效。方法62例具有介入治疗指征的中晚期肝癌患者随机均分为2组,对照组31例单独行TACE治疗,观察组31例行TACE联合RFA治疗。比较观察2组的临床疗效及AFP水平。结果观察组总有效率为87．1％,高于对照组的51．6％（P〈0．05）。观察组术后AFP水平明显低于对照组（P〈0．05）。随访24个月各时期的生存率观察组均明显高于对照组（P〈0．05）。结论TACE联合RFA治疗中晚期肝癌安全、可靠,可提高患者生存率,延长患者生存时间,疗效优于单独应用TACE。     

肝动脉化疗栓塞术联合支持治疗伴HBV感染的中晚期原发性肝癌

[目的]探讨肝动脉化疗栓塞术（TACE）联合支持治疗对伴有乙肝病毒（HBV）感染的中晚期原发性肝癌（PLC）的疗效。[方法]入组伴有HBV感染的中晚期PLC 52例,分为支持治疗组和TACE组,其中支持治疗组给予支持治疗和抗病毒治疗,TACE组在支持治疗和抗病毒治疗的同时给予TACE治疗。治疗结束后分别评价两组的疗效和不良反应。[结果]支持治疗组和TACE组术后1年血清HBV DNA转阴率分别为45.0%和46.9%,差异无统计学意义（P〉0.05）。两组有效率分别为30.0%、59.4%,疾病控制率分别为55.0%、87.5%,差异均有统计学意义（P〈0.05）;1年生存率分别为40.0%、75.0%,2年生存率分别为5.0%、37.5%,差异均有统计学意义（P〈0.05）;中位生存期分别为10个月和19个月;生活质量改善率分别为80.0%和84.4%（P〉0.05）。支持治疗组无明显不良反应出现,TACE组主要不良反应为恶心呕吐和骨髓抑制,但均为Ⅰ～Ⅱ度。[结论]TACE联合支持治疗应用于伴有HBV感染的中晚期PLC患者疗效较好,且不良反应可耐受。     

热疗联合TACE治疗中晚期肝癌的临床观察

目的评价热疗联合动脉灌注栓塞术(TACE)治疗中晚期肝癌的临床疗效及毒副反应。方法选取中晚期肝癌患者80例,随机分成两组,每组40例。A组采用局部区域热疗联合TACE,B组仅行TACE。两组病例均在TACE 1~2疗程后进行临床疗效及毒副反应的评价。结果A组病例中卡氏评分提高占80%（32/40）;B组病例中卡氏评分提高占47.5%（19/40）（P＜0.05)。A组与B组病例的临床近期疗效分别为：CR 0%、0%;PR72.5%、45%;SD 20%、37.5%;PD7.5%、17.5%（P＜0.05）,且不增加毒副反应。A组病例的T细胞亚群和NK细胞的活性均明显高于治疗前,而B组的T细胞亚群和NK细胞的活性均低于治疗前（P＜0.05）。结论热疗联合TACE治疗中晚期肝癌可提高介入治疗肝癌的近期疗效,减轻毒副作用,且对患者的免疫功能有保护作用,值得临床推广运用。     

恩度肝动脉灌注联合介入化疗栓塞治疗中晚期肝癌的临床观察

目的: 探讨恩度肝动脉灌注联合介入化疗栓塞治疗中晚期肝癌的疗效及安全性。 方法: 选取30例中晚期肝癌患者入组研究,均给予恩度肝动脉灌注联合介入化疗栓塞治疗,同时选取30例中晚期肝癌患者作为对照组,仅行介入化疗栓塞治疗。于1～2个治疗周期后比较RECIST疗效,甲胎蛋白转阴率及生活质量评分,同时比较治疗副作用。 结果: 实验组30例患者中29例可评价疗效。实验组治疗后K氏评分显著升高(80.39±8.37Vs73.93±9.22,P=0.002);恩度治疗组的治疗有效率及甲胎蛋白转阴率显著高于对照组(P=0.021,P=0.046)。治疗副作用轻微。 结论: 采用恩度肝动脉灌注联合介入化疗栓塞治疗中晚期肝癌,患者生活质量及近期疗效提升明显,甲胎蛋白转阴率亦有明显改善,而治疗相关副作用不大,值得临床推广及进一步研究。     

Quality of Life after Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation in Patients with Unresectable Hepatocellular Carcinoma Compared with Transcatheter Arterial Chemoembolization alone

Aim: The aim of this study was to assess quality of life (QoL) in patients with unresectable hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) compared to TACE plus radiofrequency ablation (RFA) done at the same sitting, and to assess tumor therapy response after these 2 palliative interventions. Methods: 73 patients with unresectable HCC (BCLC-B) were included. Patients with tumor ≤ 5 cm were subjected to TACE (N = 45) while patients with tumors > 5 cm were subjected to TACE followed immediately by RFA (N = 28). QoL was evaluated with two validated questionnaires (EORTC QLQ-30 and EORTC HCC18). These questionnaires were filled out before intervention, 2 weeks and 2 months after intervention. Pre/post interventional changes were analyzed. The modified response evaluation criteria in solid tumor (mRECIST) were employed for the evaluation of therapeutic efficacy. Results: Baseline global health status/QoL was significantly higher in TACE group (64.1%) compared to TACE-RFA group (51.2%). Two weeks after intervention: the absolute decrease in global health state was higher in TACE-RFA (- 12.1%) compared to TACE (- 6.3%, p = 0.411). Less impairment was found in TACE group compared to TACE-RFA group for physical/social functioning, fatigue and pain but it was statistically insignificant. Two months after intervention; TACE-RFA group showed significant improvement in global health score, social and physical functioning scores, as well as significant improvement in pain and fatigue compared to TACE group. The therapeutic efficacy of TACE-RFA was better than TACE alone: complete remission, partial remission, stable disease and progressive disease were 17.9%, 32.1%, 42.9% and 7.1% Vs11.1%, 22.2%, 48.9% and 17.8%, respectively). Conclusion: Neither TACE nor TACE-RFA showed a significant decrease in QoL in patients with unresectable HCC two weeks after intervention. However, two months after intervention; TACE-RFA showed significant improvement in global health score compared to TACE monotherapy. TACE-RFA appeared safe, effective and more favorable than TACE monotherapy.     

Efficacy of Prophylactic Entecavir for Hepatitis B Virus- Related Hepatocellular Carcinoma Receiving Transcatheter Arterial Chemoembolization

Background and Aims: Hepatitis B virus (HBV) reactivation was reported to be induced by transcatheter arterial chemoembolization (TACE) in HBV-related hepatocellular carcinonma (HCC) patients with a high incidence. The effective strategy to reduce hepatitis flares due to HBV reactivation in this specific group of patients was limited to lamivudine. This retrospective study was aimed to investigate the efficacy of prophylactic entecavir in HCC patients receiving TACE. Methods: A consecutive series of 191 HBV-related HCC patients receiving TACE were analyzed including 44 patients received prophylactic entecavir. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 copies/ml higher than nadir the level, and hepatitis flares due to HBV reactivation were the main endpoints. Results: Patients with or without prophylactic were similar in host factors and the majorities of characteristics regarding to tumor factors, HBV status, liver function and LMR. Notably, cycles of TACE were parallel between the groups. Ten (22.7%) patients receiving prophylactic entecavir reached virologic response. The patients receiving prophylactic entecavir presented significantly reduced virologic events (6.8% vs 54.4%, p=0.000) and hepatitis flares due to HBV reactivation (0.0% vs 11.6%, p=0.039) compared with patients without prophylaxis. Kaplan-Meier analysis illustrated that the patients in the entecavir group presented significantly improved virologic events free survival (p=0.000) and hepatitis flare free survival (p=0.017). Female and Eastern Cooperative Oncology Group (ECOG) performance status 2 was the only significant predictors for virological events in patients without prophylactic antiviral. Rescue antiviral therapy did not reduce the incidence of hepatitis flares due to HBV reactivation. Conclusion: Prophylactic entecavir presented promising efficacy in HBV-related cancer patients receiving TACE. Lower performance status and female gender might be the predictors for HBV reactivation in these patients.     

肝癌术后预防性肝动脉化疗栓塞对延缓复发的意义

[目的]了解预防性肝动脉化疗栓塞术(TACE)在延缓肝癌手术后复发方面的作用.[方法]对823例行根治性切除并经病理证实为肝细胞癌患者进行随访分析.其中126例患者手术后行预防性TACE,将可能影响原发性肝癌术后复发的观察指标包括性别、年龄、术前AFP、有无癌栓、手术切缘、手术前肿瘤是否破裂、肿瘤大小、肿瘤有无子灶、肿瘤包膜情况、手术后有无行预防性TACE等,用Cox模型分析各因素与复发时间之间的关系.所有数据经SAS6.12和SPSS统计软件处理分析.[结果]年龄小、有癌栓、手术前肿瘤有破裂、肿瘤体积大和肿瘤周围有子灶等因素使肝癌手术后复发时间提前,保证较大手术切缘距离和手术后行预防性TACE可延缓肝癌手术后复发.预防性TACE可明显降低肝癌患者术后2年的复发率.[结论]对有早期复发病理学征象的肝癌患者行预防性TACE治疗可能延缓术后肿瘤复发.     

Health-Related Quality of Life of Patients with Intermediate Hepatocellular Carcinoma after Liver Resection or Transcatheter Arterial Chemoembolization

Background: The aim of our present study was to compare quality of life (QoL) between intermediate-stage(BCLC-B) HCC patients who had undergone either liver resection or transcatheter arterial chemoembolization(TACE). Materials and Methods: A total of 102 intermediate-stage HCC patients participated in our study,including 58 who had undergone liver resection and 44 who had undergone TACE. Baseline demographiccharacteristics, tumor characteristics, and long-term outcomes, such as tumor recurrence, were compared andanalyzed. QoL was assessed using the Short Form (SF)-36 health survey questionnaire with the mental andphysical component scales (SF-36 MCS and PCS). This questionnaire was filled out at HCC diagnosis and 1,3, 6, 12, 24 months after surgery. Results: For the preoperative QoL evaluation, the 8 domains related to QoLwere comparable between the two groups. The PCS and MCS scores were significantly decreased in both theTACE and resection groups at1 month after surgery, and this decrease was greater in the resection group.These scores were significantly lower in the resection group compared with the TACE group (P<0.05). However,these differences disappeared at 3 and 6 months following surgery. One year after surgery, the resection groupshowed much higher PCS scores than the TACE patients (P=0.018), and at 2 years after surgery, the PCS andMCS scores for the resection group were significantly higher than those for the TACE group (P<0.05). Elevenpatients (19.0%) in the resection group and 17 (38.6%) in the TACE group suffered HCC recurrence (P<0.05).Univariate and multivariate analyses indicated that tumor recurrence (HR=1.211, 95%CI: 1.086-1.415, P=0.012)was a significant risk factor for poorpostoperative QoL in the HCC patients.Conclusions: Due to its effectson reducing HCC recurrence and improving long-term QoL, liver resection should be the first choice for thetreatment of patients with intermediate-stage HCC.