双介入法联合三氧化二砷治疗肝胆管细胞癌

目的：探讨经皮微波凝固（PMCT）和肝动脉化疗栓塞（TACE）联合三氧化二砷（As2O3）治疗肝胆管细胞癌（IHCC）的疗效和机制。方法：对32例IHCC共68个目标病灶,先在超声引导下行PMCT,然后行TACE,再静脉滴注As2O310mg/d,连用3周为1个疗程,间歇2周重复。结果：经3个疗程治疗后,患者的疾病控制率（DCR）为71.9%,CA199转阴率50.0%（11/22）,肿瘤坏死率52.4%（22/42）,中位生存期20个月,1年生存率71.9%,2年生存率达到37.5%。结论：本研究初步表明,PMCT＋TACE联合As2O3治疗IHCC是一种比较安全、有效、合理的综合治疗方法。

Percutaneous microwave coagulation therapy and transcatheter arterial chemoembolization with arsenic trioxide for cholangiocarcinoma

Objective:To study the efficacy and possible mechanism of percutaneous microwave coagulation therapy(PMCT) and transcatheter hepatic arterial chemoembolization(TACE) combined with arsenic trioxide(As2O3) in treating intrahepatic cholangiocarcinoma(IHCC).Methods:A total of 68 nodules of IHCC in 32 patients were treated with ultrasound-guided PMCT and TACE,then As2O3 injection,10mg iv qd for 3 weeks.It was repeated after 2 weeks.Results:After 3 cycles,patients response rates was 71.9%,the rate of normalized CA199 was 50.0%(11/22),tumor necrosis was 52.4%(22/42),median survival time was 20 months,1-year and 2-year survival rates was 71.9% and 37.5%,respectively.Conclusion:The initial study indicated that combination of PMCT,TACE and As2O3 therapy for IHCC is a safe,effective and rational modality.