动脉栓塞化疗联合激光消融治疗肝癌的临床研究  

Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma

作　　者：周泽健[1] 许荣德[1] 李伟科[1] 庄文行[1] 陆骊工[1] 邵培坚[1] 陈晓明[1] 罗鹏飞[1] 

机构地区：[1]广东省人民医院肿瘤中心介入科,广东广州510080

出　　处：《南方医科大学学报》2007年第12期1866-1868,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(20042270031)~~

摘　　要：目的以动脉栓塞化疗联合经皮无水乙醇注射消融(TOCE+PEI)疗法为对照组,通过前瞻性临床随机对照研究,探讨动脉栓塞化疗联合激光消融(TOCE+ILT)治疗肝癌的疗效和毒副反应。方法120例原发性肝癌患者随机进入研究组和对照组,分别接受TOCE+ILT和TOCE+PEI治疗,两组疗法均可重复操作,直至CT显示肿瘤消融完全为止,治疗后进行疗效评价和随访。结果120例患者中完成2年随访者105例,其中研究组54例,对照组51例,研究组完全坏死率显著高于对照组(84.8%vs73.9%,X2=4.405,P=0.036);研究组AFP转阴率显著高于对照组(77.8%vs56.1%,X2=4.592,P=0.032);两组1年生存率分别为92.6%和88.2%,无统计学差异,2年生存率分别为79.6%和60.8%,研究组显著高于对照组(!2=4.477,P=0.034)。两组患者治疗前肝功能指标无统计学差异,治疗结束后1周研究组谷丙转氨酶升高幅度显著低于对照组(95.90±56.06U/Lvs116.31±45.27U/L,t=2.04,P=0.043)。两组患者治疗后均有程度不等的栓塞后综合征反应,无严重并发症发生。结论TOCE+ILT疗法治疗肝癌疗效好,副作用小,是一种值得推广的治疗模式。Objective To evaluate the therapeutic effects and adverse effects oftransarterial oily chemoembolization combined with interstitial laser thermotherapy （TOCE＋ILT） in the treatment ofhepatocellular carcinoma. Methods Totally 120 patients with hepatocellular carcinoma were randomized into two groups and received interventions with TOCE＋ILT or TOCE combined with percutaneous ethanol injection （TOCE＋PEI）. The treatment was repeated when necessary until the tumor was completely ablated, after which the therapeutic effects were evaluated and the patients were the followed up for observing long-term clinical outcome. Results Of the 120 patients enrolled in this observation, 105 were followed up for two years （54 in TOCE＋ILT group and 51 in TOCE＋PEI group）. The complete tumor necrosis rate of TOCE＋ILT group was significantly higher than that of the TOCE＋PEI group （84.8% vs 73.9%, χ^2=4.405, P=0.036）, and TOCE＋ILT was associated with a significantly higher negative conversion rate ofAFP positivity （77.8% vs 56.1%, χ^2=4.592, P=0.032）. The 1-year survival rate were similar between two groups, but the 2-year survival rate was significantly higher in patients with TOCE＋ILT （79.6% vs 60.8%, χ^2=4.477, P=0.034）. The hepatic function was comparable between the two groups before treatment, and 1 week after treatment, the ALT level in patients undergoing TOCE＋ILT was significantly lower than that in patients with TOCE＋PEI （95.90±56.06 U/L vs 116.31±45.27 U/L, t=2.04, P=0.043）. Post-embolization syndrome was observed in the patients in two groups, but no severe adverse events were found. Conclusion TOCE＋ILT has good therapeutic effects and mild side effects in the treatment ofhepatocellular carcinoma.

关 键 词：肝肿瘤 化学栓塞 治疗性 激光消融 无水乙醇 

分 类 号：R735.7[医药卫生—肿瘤]