多模式系列疗法治疗老年原发性肝癌153例分析

目的 探讨多模式系列疗法治疗老年原发性肝癌患者的可行性和临床疗效。方法 接受多模式系列治疗的老年(≥60岁)原发性肝癌患者153例,其中行肝切除术37例,深度冷冻治疗32例,非手术治疗84例(介入治疗为主8l例,局部治疗配合介入治疗为主3例)。行肝切除和冷冻治疗者,术后配合多疗程介入治疗,全部患者均配合生物免疫治疗和中药治疗。结果 肝切除术患者l,3,5年生存率分别为78.4％、46．4％和35．7％,无手术死亡。冷冻治疗者l,3,5年生存率分别为64.5％、40．9％和25.0％,手术死亡率为3.l％。非手术治疗患者中,8l例介入治疗者的l,3,5年生存率分别为47．5％、23．5％和4．3％,手术死亡率为1．2％;3例局部治疗配合介入治疗者已分别生存2．5,3．8和7．1年。结论 多模式系列治疗对老年原发性肝癌患者疗效确切,安全性亦好,是可行而有效的治疗方法;多模式系列治疗方法中,应优先采用外科治疗。

Multi-modal serial therapy for primary liver cancer in senile patients: a report of 153 cases

OBJECTIVE: To study the feasibility and validity of multi-modal serial therapy for primary liver cancer in senile patients. METHODS: 153 senile primary liver cancer patients (>or= 60 years) were given multi-modal serial therapy from June 1993 to December 2000. Hepatectomy was performed in 37, deep cryosurgery in 32 and non-operative therapy in 84 (intervention as chief therapy in 81, combined local and intervention therapy in 3). The multi-course intervention therapy was given postoperatively in hepatectomy and cryosurgery groups, while bioimmunotherapy and traditional Chinese medicine were used in all groups. RESULTS: The 1-, 3- and 5-year survival rates in the hepatectomy group were 78.4%, 46.4% and 35.7%, without operative mortality. The 1- and 3- and 5-year year survival rates in the cryosurgery group were 64.5%, 40.9% and 25.0% with mortality of 3.1%. Among patients with non-operative therapy, the 1- and 3- and 5-year year survival rates in intervention group were 47.5%, 23.5% and 4.3%. The operative mortality was 1.2%. The 3 patients who received combined local and intervention therapy have survived for 2.5, 3.8 and 7.1 years. CONCLUSION: Multi-modal serial therapy with surgical treatment as the chief means, being precise in the effect and good in safety, is feasible and valid for primary liver cancer in senile patients.