125I粒子组织间植入联合TACE治疗巨块型肝癌的临床观察

目的探讨125I粒子组织间植入联合肝动脉灌注化疗栓塞(TACE)治疗巨块型肝癌的临床疗效。方法选取40例不适宜手术治疗的巨块型肝癌患者,其中17例患者经单一TACE治疗,23例患者行125I粒子植入联合TACE治疗。联合治疗组患者于TACE治疗后1周,经计算机三维治疗计划系统(TPS)制定计划,CT引导下行125I粒子植入,粒子放射活度为29.6MBq。粒子植入后定期CT随访,观察比较疗效。结果 3个月后增强CT复查,125I粒子联合TACE治疗组完全缓解(CR)3例,部分缓解(PR)16例,稳定(SD)3例,总有效率(CR+PR)为82.61%;随访6～24个月,1年生存率为52.17%,2年生存率为39.13%。结论 125I粒子植入联合TACE治疗巨块型肝癌可以提高局部控制率,临床疗效确切,安全性高,并发症少。

Clinical Efficacy of 125I Seeds Implantation Combined with TACE for Huge-type Hepatoma

OBJECTIVE To observe the clinical efficacy of 125I seeds implantation combined with TACE for huge-type hepatoma. METHODS 1 week after TACE treatment, 23 patients from October 2006 to July 2011 were implanted by CT-guided, according to the treatment planning system（TPS）, each 125I seed with particle radioactivity 29.6 MBq. Clinical efficacy were observed. RESULTS For group, complete remission（CR） was observed in 3 patients, partial remission（PR） in 29 patients, stable diseasc（SD） in 3 patients, clinical effective rate was 82.61%（CR＋PR）. During a follow-up period of 6 to 24 months, the one-year and two-year survival rate was 52.17% and 39.13% respectively. CONCLUSION 125I seeds implantation combined with TACE can markedly improve the local disease effect of huge-type hepatoma, it is a safe way and with good clinical effect and lower complications.