冷冻消融联合化疗治疗中晚期原发性肝癌的临床研究

目的评价氩氦刀冷冻消融联合吉西他滨＋草酸铂方案治疗中晚期肝癌的安全性、临床价值及疗效。方法按照前瞻性随机分组原则,把符合入组条件的50例中晚期原发性肝癌病人分为2组：对照组（单纯氩氦刀治疗组）25例,治疗组（氩氦刀联合化疗组）25例,观察两组治疗后近期疗效、肿瘤初次复发率、1年生存率、治疗前后生活质量（KPS评分）变化及不良反应。结果 ：两组治疗后总有效率分别为60%（15/25）、84%（21/25）,肿瘤初次复发率分别为56%（14/25）、24%（6/25）,1年生存率分别为56%（14/25）、76%（19/25）,生活质量KPS评分值均比治疗前有不同程度提高,对照组无骨髓抑制发生,两组间总有效率、肿瘤初次复发率、1年生存率、治疗后KPS评分值的差异均有统计学意义。结论氩氦刀联合吉西他滨＋草酸铂方案治疗中晚期肝癌效果明显优于单纯氩氦刀治疗效果,是一种疗效肯定、安全可靠、具有推广价值的中晚期肝癌综合治疗方法,远期疗效有待进一步观察。

Cryoablation combined with chemotherapy in the treatment of advanced primary liver cancer

Objective：To evaluate the safety,clinical value and efficacy of cryoablation ablation combined with gemcitabine ＋ oxaliplatin in the treatment of advanced liver.Methods：Fifty cases of primary liver cancer patients were divided randomly into 2 groups：control group（simple cryosurgical treatment group） and treatment group（argon-helium Knife chemotherapy group）.The curative effect,tumor recurrence rate,1-year survival rate,quality of life before and after treatment（KPS） and the adverse effects were observed.Results：After treatment,the total effective rate of two groups were 60%（15/25）,84%（21/25） respectively.Tumor recurrence rate were 56%（14/25）,24%（6 /25）,and 1 year survival rates were 56%（14/25）,76%（19/25）.KPS score were improved after treatment.In the control group no bone marrow suppression occurred.There were significant differences in the total effective rate,tumor the recurrence rate,1-year survival rate and KPS score between the two groups.Conclusion：The effect of cryoablation ablation combined with Gemcitabine ＋ oxaliplatin in the treatment of advanced liver cancer is better than that of cryosurgical treatment,and it is effective and safe and reliable,with higher value in the comprehensive treatment of advanced hepatocellular carcinoma.Long-term observation is needed.