经肝动脉栓塞化疗联合微波刀治疗中晚期肝癌的临床疗效分析  

Clinical Application of Transcatheteral Arterial Chemoembolization and Percutaneous Microwave Coagulation Therapy for Primary Hepatocellular Carcinoma

作　　者：段巨涛[1] 孔棣[1] 柴友龙[1] 

机构地区：[1]天津市南开医院第四外科,天津市300100

出　　处：《中国肿瘤临床》2011年第20期1283-1286,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨联合应用经肝动脉化疗栓塞联合微波刀治疗中晚期肝癌的临床应用价值。方法:收集经病理、AFP和(或)影像学证实的不能手术切除的中晚期肝癌患者63例,按治疗方法随机分为经肝动脉化疗栓塞治疗组和经肝动脉化疗栓塞联合微波刀治疗组,经肝动脉化疗栓塞治疗组31例,联合治疗组32例。结果:经肝动脉化疗栓塞治疗组与联合治疗组治疗后患者AFP定量平均下降率分别为52.2%(12/23)和80.0%(20/25),两组间差异有统计学意义(P<0.05);经肝动脉化疗栓塞治疗组的完全坏死率为12.9%(4/31);而联合治疗组的完全坏死率为34.4%(11/32),经统计学分析两组有明显统计学意义。经肝动脉化疗栓塞治疗组在1个疗程治疗结束6个月后复查影像学发现肝癌复发率为32.3%(10/31);联合治疗组肝癌复发率为9.4%(3/32),两者间差异有显著意义(P<0.05)。经肝动脉化疗栓塞治疗后患者1年的生存率为64.5%(18/31),而经联合治疗后患者1年生存率为87.5%(28/32),两组间差异有统计学意义(P<0.05)。结论:经肝动脉化疗栓塞联合微波消融治疗可显著提高中晚期肝癌患者的生存率,延长患者生存期。Objective： To evaluate the efficacy of transarterial chemoembolization （ TACE ） combined with percutaneous microwave coagulation therapy （ PMCT ） in treatment of hepatocellular carcinoma （ HCC ）. Methods： Sixty-three HCC patients, confirmed by pathology, AFP, and （ or ） imaging, were divided into the TACE group and the TACE combined with PMCT group. The TACE group included 31 cases, and the TACE combined with PMCT group included 32 patients. Results： The average rate of decline in a-fetopro- tein （ AFP ） in the TACE treatment group and the TACE combined with PMCT group were 52.2% （ 12/23 ） and 80.0% （ 19/25 ）, respec- tively, which were significantly different （ P 〈 0.05 ）. Complete necrosis occurred in 12.9% （4/3 l） of the TACE group and 34.4% （ 11/ 32 ） of the combined treatment group. The difference between the two groups was statistically significant. At 6 months after the end of the imaging findings, the recurrence rate in the TACE group was 32.3% （ 10/31 ）, whereas the recurrence rate in the combined treat- ment group was 9.4% （ 3/32 ）. The difference between the two groups was significant （ P〈 0.05 ）. One year after treatment, the survival rate in the TACE group was 64.5% （ 18/31 ）, whereas that in the combined treatment group was 87.5% （ 28/32 ）. The difference be- tween the two groups was significant （ P 〈 0.05 ）. Conclusion： TACE combined with PMCT significantly increases the survival rate of patients with advanced liver cancer and prolongs their survival.

关 键 词：原发性肝癌 经肝动脉化疗栓塞术 微波消融术 

分 类 号：R735.7[医药卫生—肿瘤]