肝动脉插管化疗栓塞术后联合HIFU治疗中晚期肝癌的疗效

目的观察肝动脉插管化疗栓塞术（TACE）后联合高强度聚焦超声（HIFU）在中晚期肝癌治疗中的疗效。方法采用TACE联合HIFU组（n=32）与单纯TACE组（n=20）对比，观察两组治疗前后肿瘤大小、血供、甲胎蛋白（AFP）的水平，随访1年，比较两组0．5年生存率，1年生存率、中位生存期有无差异。结果①经过治疗，两组的肿瘤缩小，肿瘤血供减少，血清AFP下降，且肿瘤缩小率、肿瘤血供消失和减少率、血清AFP水平下降在两组间差异有统计学意义（P＜0．05）。②单纯的TACE治疗者有效率78．13％，0．5年生存率84．38％，1年生存率68．75％，中位生存期9．7月；TACE加HIFU治疗者有效率90．00％，0．5年生存率95．00％，1年生存率85．00％，中位生存期11．2月，差异均有统计学意义（P〈0．05）。结论TACE联合HIFU是中晚期肝癌行之有效的治疗方法，其疗效略优于单纯TACE。但尚需大规模的临床随机试验进一步证实。

Effect of transcatheter arterial chemoembolization combined with ultrasound ablation on hepatocellular carcinoma at middle and advanced stages

Objective To evaluate the efficacy of transcatheter arterial chemoembolization（TACE）combined with highintensity focused ultrasound ablation in the treatment of hepatocellular carcinoma （HCC）at middle and advanced stages. Methods There 52 HCC patients at middle and advanced stage were alternately enrolled in one of two treatment groups： group 1 （n=32）,in which TACE was used alone, and group 2 （n=20）,in which transcutaneous ablation of HCC with highintensity focused ultrasound was used 2-4 weeks after TACE. The changes of tumor size,tumor vascular supply and serum alpha-fetoprotein in two groups before and after therapy were observed. Results Significant differences in tumor size, absence or reduction of blood supply, decrease of serum alpha-fetoprotein were observed after treatment in the two groups. The effective rate was 78.13% in group 1 and 90% in group 2. The 6-month survival rate was 95.00% in group 2 and 84.38% in group 1 ,and the 1-year survival rate was 85% and 68.75% ,respectively. The median survival time was 11.2 months in group 2 and 9.7 months in group 1. Conclusion The combination of TACE and high-intensity focused ultrasound ablation is a promising approach for treatment of HCC patients at middle and advanced-stage .