氩氦刀冷冻消融联合TACE治疗巨大肝癌的临床观察

目的 探讨氩氦刀冷冻消融联合经肝动脉化疗栓塞（TACE）治疗巨大肝癌的有效性和安全性。方法 回顾性分析本院2006年9月至2011年8月收治的巨大肝癌患者85例，其中观察组44例先行1～2次TACE，1个月后序贯氩氦刀治疗1～3次，而对照组41例仅行单纯TACE治疗。按照实体瘤的疗效评价标准（RECIST）1.0版评价疗效并随访生存。结果 观察组有效率（RR）为70.5％，高于对照组的46.3％（P＜0.05）；观察组1、2和3年生存率分别为77.3％、56.8％和36.4％，中位生存时间为19.2个月，均高于对照组的51.2％、36.6％、14.6％和11.8个月（P＜0.05）；两组患者的不良反应均为轻中度且可耐受。结论 氩氦刀联合TACE治疗具有互补增效作用，且安全微创，为巨大肝癌的综合治疗提供了新的途径。

Clinical observation of argon-helium knife cryotherapy combined with transcatheter arterial chemoemboli-zation (TACE) on huge liver cancer

Objective To explore the efficacy and safety of argon-helium knife cryotherapy combined with transcatheter arterial chemoembolization （TACE） on huge hepatocellular carcinoma. Methods Eighty-five patients with huge liver cancer from September 2006 to August 2011 were analyzed retrospectively. Observation group （n=44） received one to two TACE and one to three argon helium knife cryotherapy after one month sequently， while the control group （n=41） received TACE treatment only. Response to chemotherapy was assessed by RECIST criteria 1.0 and follow-up data was investigated. Results The response rate of observation group was 70.5％， higher than 46.3％ of the control group （P＜0.05）. The 1-， 2-， 3-year survival rates of observation group were 77.3％， 56.8％ and 36.4％， and medium overall survival time was 19.2 months， which were all higher than the 51.2％， 36.6％， 14.6％ and 11.8 months of control group （P＜0.05）. The adverse reaction of both groups were mild-to-moderate and tolerable. Conclusion Argon-helium knife cryotherapy combined with TACE has synergism effect and minimally invasive， and provide a new regiem for comprehensive treatment on huge hepatocellular carcinoma.