热疗加介入治疗原发性肝癌临床观察

目的　观察热疗加介入治疗原发性肝癌的临床治疗效果。方法　自1995年8月～1998年12月，采用BSD2000型热疗机，Sigma60辐射器局部区域热疗联合介入治疗原发性肝癌20例。所有病例均为男性，平均年龄49.2岁，肿瘤大小6cm×7cm×8cm～13cm×15cm×17cm。采用高电阻铅测温针肿瘤内测温。每次热疗40～60min，20例共热疗33次，75%的病例热疗1次，热疗达到的平均温度为41.7℃，其中25次(75.8%)热疗肿瘤内温度达41℃以上。介入治疗采用动脉导管化疗加栓塞，先导管内注入PDD80mg，5-FU1500mg，EADM50～60mg，然后注入EADM10mg和碘油混合液进行栓塞。结果　显效6例占30%，有效7例占35%。中位生存期为10个月。1年生存率为35%，2年生存率为10%。全部病例均计算TEM42.5℃，TEM42.5℃≥20者11例，20～10者7例，＜10者2例。结论　采用BSD2000型热疗机和Sigma60辐射器热疗是治疗原发性肝癌的有效手段，尤其是和介入治疗联合应用。

Clinical observation of hyperthermia combined with interventional treatment for primary liver cancer

Objective　To study the clinical efficacy of local hyperthermia combined with interventional treatment for liver cancer.Methods　From August 1995 to December 1998,20 patients with primary liver cancer(males,age ranged from 34～62 years old,mean 49.2 years old) were locally treated with hyperthermia(using BSD 2000 and Sigma 60 radiator) combined with interventional treatment.The size of tumor was 6 cm ×7 cm×8 cm to 13 cm×15 cm×17 cm.During the hyperthermia,the tumor temperature was directly measured by thermometer with high resistance lead.Each thermotherpy was 40～60 min.Of interventional treatment,the transcatheter arterial chemotherapy(such as PDD 80 mg,5-FU 1.5 g,EADM 50～60 mg) and embolization(using mixture of iodipin and EADM 10 mg) was used and combined with hyperthermia.Results　After treatment,the excellent in effects was 30%(6 cases),the effective 35%(7 cases).Median survival interval was 10 months.The survival rate of 1-year was 35%,2-year 10%.75% patients took one hyperthermia,all together,20 cases took 33 times of hyperthermia.The tumor temperature was averagely 41.7℃(40.7～42.7℃).Among them,the temperature over 41.0℃ was 25 times(75.8%).The thermal dose of TEM 42.5℃ was calculated.Conclusion　It shows that BSD 2000 heating apparatus and Sigma 60 radiator have better efficacy for primary liver cancer,especially combined with interventional treatment.