125Ⅰ放射性粒子联合TACE治疗原发性肝癌的临床观察

目的：观察125 I放射性粒子联合经肝动脉化疗栓塞（trans catheter arterial ehemoembolization，TACE）治疗原发性肝癌的临床疗效及安全性。方法：选取2010—09—12—2012—08—26广西医科大学附属肿瘤医院的原发性肝癌患者53例，其中行125 I放射性粒子联合TACE治疗的27例患者作为治疗组，单纯行TACE治疗的26例患者作为对照组，观察2组患者的中位疾病进展时间（median time to progression，mTTP），并分析有效率（responserate，RR）、疾病控制率（disease control rate，DCR）及安全性。结果：治疗组与对照组mTTP分别为8．3和5．7个月，差异有统计学意义，P=0．020；中位生存时间分别为11．2和8．5个月，差异有统计学意义，P=0．010。125 I放射性粒子植入后2个月，治疗组与对照组RR分别为70．4％（19／27）和26．9％（7／26），差异有统计学意义，P=0．002；DCR分别为81．5％（22／27）和53．8％（14／26），差异有统计学意义，P=0．042。2组患者均未发生严重不良反应。结论：125 I放射性粒子联合TACE治疗原发性肝癌可延长患者的mTTP，并可提高RR及DCR，且安全性较好。

Clinical observation of 125 I seeds in combination with transarterial arterial chemoembolization in patients with advanced hepatocellular carcinoma

OBJECTIVE：To define the safety and effectiveness of combination of 125 I seeds and transarterial chemo- embolization in treatment of advanced hepatocellular carcinoma. METHODS：Fifty-three cases of unresectable hepatocellu- lar carcinoma were selected and 27 of them treated with 125I seeds combined with TACE and 26 patients treated with TA- CE alone. Median time to progression （mTTP）,response rate （RR）, disease control rate （DCR） and toxicity were as- sessed. RESULTS：The median time to progression （mTTP） was 8.3 months among the 26 patients in the 1251 seeds-TA- CE group and 5.7 months among the 26 patients in the TACE group （P= 0. 020）, this was significant different in two groups. The rate of response among patients in 125I seeds-TACE group was significantly increased [70. 4% （19/27） vs. 26.9% （7/26）, P= 0. 002] and the same to the rate of disease control [81.5% （22/27） vs. 53.8% （14/26）, P= 0. 042]. The median overall survival in the treatment group was 11.2 months,as compared with 8. 5 months for the control group （P= 0. 010）. Adverse events were similar in the two groups and were well tolerated. CONCLUSION： As compared with TACE alone, 125I seeds combined with TACE has an increased time of TTP and a significant treatment advantage without substantial toxicity.