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。

Clinical Observation of Transcatheter Arterial Chemoembolization(TACE) with Hyperthermia in Treatment of Mid and Advanced Primary Hepatic Carcinoma

Objective To evaluate the efficacy and side effects of hyperthermia and transcatheter arterial chemoembolization in the treatment of mid and advanced primary hepatic carcinoma. Methods Eighty patients of mid and advanced primary hepatic carcinoma were randomly divided into two groups，with 40 cases in each one， Group A was treated with transcatheter arterial chemoebolization in combination with hyperthermia. Group B was treated with interventional arterial chemoembolization alone.Treatment response in both groups were evaluated as well as side effects after one or two cycles. Results As to Group A,Karnofsky score had been improved in 32 cases,accounting for 80%(32/40);compared with 47.5%(19/40）in Group B.There was significant difference（P＜0.05).The immediate respone of both groups after treatment were CR 0%，0%；PR72.5%，45%；SD 20%，37.5%；PD7.5%，17.5%,in group A vs.group B,respectively.There was significant difference(P＜0.05).There was no significant difference of side effects in both groups.T lymphocytes CD₃₊，CD₄₊ proportion and CD₄₊/CD₈₊ ratio and NK cell activity increased markedly in Group A,and decreased in Group B.There were significant difference（P＜0.05 ）. Conclusion The combination of transcatheter arterial chemoembolization and hyperthemia in the treatment of the mid and advanced primary hepatic carcinoma is more effective and less detrimental than transcatheter arterial chemoembolization alone,which can protect immune function of the patients.