TACE和微波凝固术联合重组人血管内皮抑素治疗大肝癌25例的临床研究  

TACE and microwave coagulation combined with recombinant human endostatin for the treatment of large liver cancer: a clinical study in 25 cases

作　　者：沈杰[1] 于学涛[1] 范晓强[1] 林勍[1] 王云飞[1] 冯华[1] 邓小龙[1] 彭龙[1] 兰红艳[1] 沈潇[1] 

机构地区：[1]解放军第455医院肿瘤科,上海200052

出　　处：《介入放射学杂志》2013年第12期995-999,共5页Journal of Interventional Radiology

基　　金：上海市长宁区卫生局科研课题(2008416001)

摘　　要：目的 探讨肝动脉化疗栓塞术（TACE）和经皮微波凝同术（PMCT）联合重组人血管内皮抑素（YH-16）治疗原发性肝细胞癌（HCC）的疗效及安全性.方法 将2008年11月—2010年11月期间符合HCC诊断标准、直径5～ 12cm不可切除的HCC患者77例,分为A、B、C3组.A组（26例）只行TACE,B组（26例）采用TACE联合PMCT,C组（25例）在B组方案上联合YH-16静脉滴注.观察比较3种疗法对患者体力状况、肿瘤指标、近期疗效、累计生存率的影响和治疗相关并发症及不良反应,以治疗后最佳疗效作为最终评价结果（mRECIST标准）.结果 ①治疗后A、B、C组客观有效率（ORR）分别为26.9％、53.9％、56.0％,疾病控制率（DCR）分别为50.0％、76.9％、92.0％,B组、C组与A组间差异有统计学意义（P＜0.05）;中位无疾病进展生存期（mPFS）分别为7.5、12.0和15.0个月,3组间差异均有统计学意义（P＜0.05）;中位总生存期（mOS）分别为13.0、20.5和21个月,B组、C组与A组间差异有统计学意义（P＜0.05）;1年和2年累计生存率分别为65.4％、88.5％、92.0％和19.2％、42.3％、44.0％,B组、C组与A组间差异有统计学意义（P＜0.05）.②治疗后体力状况改善C组优于B组（P＜0.05）、B组优于A组（P＜0.05）;A、B和C组AFP下降50％的比率分别为38.9％、61.1％、70.6％,肝外转移灶比率分别为57.7％、61.5％和44.0％.③各组均无治疗相关的严重并发症及明显不良反应.结论 双介入法治疗大肝癌安全、有效,联合YH-16治疗大肝癌可提高患者生存质量,有望减少肝外转移概率.Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization （TACE） and percutaneous microwave coagulation therapy （PMCT） combined with recombinant human endostatin （YH-16） in treating hepatocellular carcinoma （HCC）.Methods During the period from November 2008 to November 2010 a total of 77 HCC patients were admitted to authors＇ hospital.All the patients met the study criteria,i.e.the liver cancer was inoperable with a diameter of 5-12 cm.The patients were divided into three groups.Patients of group A （n =26） received TACE only,patients of group B （n =26） received TACE together with PMCT,and patients of group C （n =25） received TACE,PMCT and intravenous infusion of YH-16.The patient＇s physical status,tumor marker levels,short-term effect,cumulative survival rate,treatment-related complications,toxicity effect,etc.were determined and compared between each other of the three groups.The best treatment efficacy was regarded as the final results and was used for evaluation （mRECIST standard）.Results ① After the treatment,the objective response rates （ORR） of group A,group B and group C were 26.9%,76.9% and 92.0% respectively,the disease control rates （DCR） of group A,group B and group C were 50.0%,76.9% and 92.0% respectively.The difference between group A and B as well as between group A and C was statistically significant （P 〈 0.05）.The median progression-free survival （mPFS） time of the group A,B and C was 7.5 months,12.0 months and 15.0 months respectively,the differences among each other of the three groups were statistically significant （P 〈 0.05）.The median overall survival （mOS） time of the group A,B and C was 13.0 months,20.5 months and 21.0 months respectively,the difference between group A and B as well as between group A and C was statistically significant （P 〈 0.05）.The 1-year and 2-year cumulative survival rates of group A,B and C were 65.4%,88.5%,92.0% and 19.2%,42.3%,44.0% respectively,the difference be

关 键 词：原发性肝癌 肝动脉化疗栓塞 微波凝固 重组人血管内皮抑素 

分 类 号：R735.7[医药卫生—肿瘤]