肝动脉化疗栓塞联合微波消融治疗肝癌的临床研究

目的通过随机对照临床研究设计,观察比较肝动脉化疗栓塞(TACE)联合微波消融(PMCT)治疗原发性肝癌的临床疗效及毒副反应。方法将我院收治的不能手术的中晚期原发性肝癌患者68例,随机分为2组,对照组(TACE)36例,联合组(TACE+PMCT)32例,两组患者之间具有可比性,两组患者先给予肝动脉化疗栓塞治疗,联合组1～2周后给予微波消融治疗。治疗结束后随访1～2年,评价两组的治疗效果及毒副反应。结果两组病例均获得完整随访。联合组1年、2年的生存率分别为71.88%和37.50%,对照组1、2年的生存率分别为44.45%和13.89%,联合组和对照组AFP的下降率分别为75.87%和47.06%,联合组优于对照组,两组均未发生严重不良反应,生活质量均得到很大程度的改善。结论肝动脉化疗栓塞(TACE)联合微波消融(PMCT)治疗原发性肝癌安全、可靠,其疗效明显优于单纯肝动脉化疗栓塞治疗,延长生存期,不增加毒副作用。

Clinical review of transcatheter hepatic arterial chemoembolization combined with microwave ablation in patients with liver cancer

Objective To evaluate the clinical effect and application value of transcatheter hepatic arterial chemoembolization(TACE) combined with percutaneous microwave coagulation therapy(PMCT)in patients with liver cancer by the randomized controlled clinical study design.Methods Sixty-eight patients with primary liver cancer of middle-late stage who could not surgery were divided into two groups.32 patients undertook therapy that combined TACE and PMCT as a therapy group,36 patients performed only with TACE were enrolled in control group.All the patients were treated with TACE first,the synthetic therapy group were treated with PMCT 1～2 weeks after TACE.Patients were followed up for 1～2 years,the therapeutic effects and side effects were evaluated between the two groups.Results Two groups of cases were followed up for complete.The survival rates in 1 and 2 years were 71.88% and 37.50% in the therapy group respectively,while were 44.45% and 13.89% in the control group respectively.The average reduced rates of AFP was 75.87% and 47.06% in the therapy group and control group respectively.The therapy group was better than that of control group,no severe effect was observed in two groups.The quality of life had been greatly improved.Conclusion TACE combined with PMCT can safety and effectively treat the patients with primary liver cancer,superior to only TACE,and can extend life span without increase side effects.