经动脉化疗栓塞序贯125I植入治疗中晚期肝癌疗效观察

【摘要】 目的 探讨经动脉化疗栓塞术(TACE)序贯125I放射性粒子植入治疗中晚期肝癌的临床疗效。方法 回顾性研究自2011年5月至2012年5月确诊为中晚期原发性肝癌的患者89例,A组45例(单纯TACE术),B组44例(TACE术后7~10天内序贯125I放射性粒子植入),125I放射性粒子植入严格遵从计算机三维治疗计划系统(TPS)的方案进行粒子布源。对比观察两组患者术后2、4个月的CT扫描显示的肿瘤局部控制有效率及术后6、9个月的生存率,两组局部控制率及术后6、9个月生存率比较采用卡方检验。 结果 随访术后第2、4月肿瘤局部控制有效率(CR+PR)A组是24.44%(11/45),17.78%(8/45),B组为54.55%(24/44),47.73%(21/44),P<0.05,两组差异比较具有统计学意义。A组术后6、9个月存活率分别是62.22%(28/45),42.22%(19/45),B组术后6、9个月存活率分别是90.91%(40/44),72.73%(32/44),两组同期P值均小于0.05,两组差异具有统计学意义。结论 经肝动脉化疗栓塞序贯125I放射性粒子植入治疗中晚期原发性肝癌临床疗效确切,提高生存率。

Curative effect of transcatheter arterial combined with mI implantation in the treatment of Middle-advanced hepatic carcinoma

Objective To discuss the therapeutic effect of transcatheter hepatic arterial chemoemb- olization （TACE） combined with radioactive particles implantation for the treatment of middle advanced hepatic carcinoma. Methods Eighty-nine cases of hepatic carcinoma were collected from May 2011 to May 2012 and retrospectively analyzed. Of 89 cases, 45 patients were underwent TACE alone （group A）, 44 were treated with TACE combined with radioactive particles implantation （group B） under the computer-assisted three-dimensional treatment planning system （TPS）. Efficacy evaluation was performed in two months, four months after operation by CT scan. The survival status was recorded in the fourth and ninth months after treatment. Efficacy evaluation and survival status were compared between two groups by chi-square test （P〈0.05）. Results The OR （CR＋PR） were 24.44% （11/45）, 17.78% （8/45） in group A, and 54.55% （24/44）, 47.73% （21/44） in group B respectively at two months and four months after operation. There were significant differences between two groups （P〈0.05）. The survival rate at six, nine months in group A （62.22%, 42.22%） were significantly lower than those in group B （90.91% ,72.73% ）,P〈0.05, Conclusion TACE combined with 125I radioactive particles implantation is an effective method for the treatment of middle- advanced hepatic carcinoma, which would also improved survival rate.