高强度聚焦超声联合肝动脉化疗栓塞治疗中晚期原发性肝癌105例分析

目的　探讨高强度聚焦超声 (HIFU)联合肝动脉化疗栓塞 (TACE)治疗中、晚期原发性肝癌 (简称中、晚期肝癌 )的临床效果。方法　从 5年来收治的中、晚期肝癌患者中 ,无机抽样选择 10 5例 ,按治疗方法不同分两组 ;其中 HIFU联合 TACE治疗 5 5例 ,为联合组 ;单纯 TACE治疗 5 0例 ,为 TACE组 ;TACE采用 5 - FU Gemcitabine灌注 ,并注射碘油栓塞。分析治疗后 3个月 ,AFP的变化和病灶的局部改变 ;计算患者平均荷瘤生存期和 1年、 3年、 5年生存率 ,将两组结果进行比较。结果　在病灶局部 ,两组均出现不同程度坏死 ;联合组的 AFP下降幅度及转阴率、平均荷瘤生存期 ,结果优于 TACE组 ;1年、 3年、 5年生存率 ,联合组为 81.2 %、 4 7.3%、 2 5 .5 % ,高于 TACE组的 75 %、 30 %、 10 % ;两组结果经统计学处理 ,差异有显著性 (P<0 .0 5～ P<0 .0 1)。结论　对中晚期肝癌 ,HIFU联合 TACE,更有利于杀灭肿瘤 ,降低 AFP,提高患者的中、长期生存率 ,改善患者预后

Clinical Study on HIFU Combined with Transcatheter Arterial Chemoembolization in Treatment of 105 Cases with Middle or Advanced Primary Liver Cancer

Objective To explore the clinical effect of high intensity focused ultrasound (HIFU)combined with transcatheter arterial chemoembolization (TACE) in the treatment of middle or advanced primary liver cancers.Methods A total of 105 patients with middle or advanced primary liver cancer were chosen from those who had been treated five years before.They were divided into two groups:50 cases were treated with TACE,and the other 55 were treated with combination of HIFU and TACE.The changes of AFP levels and the targeted tumors after three month treatment were analyzed and compared with each other.The average survival time and the survival rates for one,three and five years were calculated with Kaplan-Meier method and compared between the two groups.Results The targeted tumors were degenerated to some extent in both groups.The combined group was superior to the other in AFP decrease and reversion and the average survival time.In the combined group,the survival rates for 1,3 and 5 years were higher than those in the TACE group with 81.2%,47.3%,and 25.5% vs 75%,30% and 10%,respectively(significant difference,P<0.05-0.01).Conclusions HIFU combined with TACE is superior to simple TACE for the management of middle or advanced primary liver cancers,and the former is more effective in controlling targeted tumors,decreasing AFP level and improving survival rates.