125I放射性粒子植入术联合射频消融在中晚期肝内胆管细胞癌治疗中的临床价值

目的 探讨放射性粒子植入联合射频消融(RFA)治疗中晚期肝内胆管细胞癌(ICC)的临床效果。 方法 选取宁波医疗中心李惠利医院及鄞州人民医院2012年6月—2014年6月收治的中晚期肝内胆管细胞癌患者48例为研究对象，采用随机数字表法将其分为对照组(24例)与观察组(24例)。观察组采用放射性粒子植入联合射频消融的治疗方法，对照组采用静脉化疗的方法。对比分析2组患者的血清肿瘤标志物水平、近期疗效和远期生存率。 结果 2组患者在治疗后，血清肿瘤标志物水平均较治疗前明显降低，且观察组明显低于对照组(均P<0.05)。观察组患者的缓解率明显高于对照组(70.83% vs. 37.50%，P＜0.05)；但2组患者的获益率比较差异无统计学意义(75.00% vs. 87.50%，P=0.267)。观察组与对照组患者1年及2年生存率比较差异无统计学意义(均P>0.05)，但观察组患者3年生存率高于对照组(P＜0.05)。 结论 RFA联合125I粒子植入术治疗ICC患者，可以提高缓解率，降低血清肿瘤标志物水平，延长患者的生存时间。 

Effects of radiofrequency ablation combined with 125I seed implantation for advanced intrahepatic cholangiocarcinomas

Objective To evaluate the curative effect of radiofrequency ablation (RFA) combined with 125I seed implantation in treatment of advanced intrahepatic cholangiocarcinoma (ICC). Methods The clinical data of 48 patients with advanced ICC confirmed by histopathological examination, in our hospital between June 2012 and June 2014 were retrospectively analyzed. A Total of 48 patients were assigned into control group and study group with 24 cases in each group. The study group received the radiofrequency ablation combined with 125I seed implantation, while the control group was administrated with systemic venous chemotherapy. The level of tumor markers, short-term results and long-term survival rates of the two groups were compared and analyzed. Results The levels of tumor biomarkers were significantly decreased in both groups after the treatment as compared with their pretreatment levels, but their decreasing amplitudes were significantly greater in the study group than those in the control group (all P<0.05). There was no statistical difference in benefit rate between the study group and control group (75.00% vs. 87.50%, P=0.267), but the response rate in the study group was significantly higher than that in the control group (70.83% vs. 37.50%, P<0.05). The 1-year, 2-year and 3-year survival rates showed no statistical difference between the two groups (all P>0.05), but the over 3-year survival rate in the study group was significantly higher than that in the control group (P<0.05). Conclusion RFA combined with 125I seed implantation for advanced intrahepatic cholangiocarcinoma can achieve good short-term effects, increase long-term survival and reduce the level of tumor markers.