射频消融术联合DC-CIK治疗中晚期肝细胞癌的疗效及其对患者生命质量的影响  

Clinical efficacy of radiofrequency ablation combined with DC-CIK and its effect on quality of life in patients with advanced hepatocellular caicinoma

作　　者：刘红梅[1] 史丽丽[2] 李金瑞[1] 钟鑫平[1] 

机构地区：[1]中国医科大学附属第一医院普通外科,辽宁沈阳110001 [2]武警辽宁省总队医院外科,辽宁沈阳110034

出　　处：《海南医学》2015年第21期3136-3140,共5页Hainan Medical Journal

基　　金：辽宁省科学技术计划项目(编号:2011225019)

摘　　要：目的观察超声引导下射频消融术联合树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)治疗中晚期肝细胞癌患者的临床疗效,并探讨其对患者生命质量的影响。方法选取中国医科大学普通外科2011年1月至2014年1月收治的156例诊断为中晚期肝细胞癌的患者,按照入选先后顺序随机分为观察组82例和对照组74例。两组患者均静脉输注DC-CIK免疫细胞治疗,观察组在细胞治疗的基础上行超声引导下经皮腹腔穿刺射频消融术,连续治疗6周,治疗前后用"肿瘤生命质量核心问卷(QLQ-C30)"进行评估并比较两组患者的生命质量,观察并记录治疗过程中的不良反应并评估两组患者近期及远期临床疗效。结果治疗后两组患者的QLQ-C30问卷中整体功能、特异性症状模块各个指标及整体生命质量评分均明显优于治疗前,且治疗后观察组上述指标均优于对照组,差异均有统计学意义(P<0.05);两组患者治疗过程中均出现发热、寒战伴高热、皮疹,且差异无统计学意义(P>0.05);观察组术后出现腹痛、恶心伴呕吐、肝周血肿;治疗后观察组近期临床疗效与对照组比较差异无统计学意义(P>0.05),但远期临床疗效优于对照组,且生存期长于对照组,差异均有统计学意义(P<0.05),且中位生存期长于对照组,差异有统计学意义(P<0.05)。结论超声引导下射频消融术联合DC-CIK能提高中晚期肝细胞癌患者的远期临床疗效与生命质量且不良反应较少。Objective To investigate the clinical efficacy of radiofrequency ablation combined with dendrit-ic cells and cytokine-induced killers （DC-CIK） and its effect on quality of life in patients with advanced hepatocellular caicinoma. Methods A total of 156 patients diagnosed with advanced hepatocellular caicinoma in our hospital from Jan. 2011 to Jan. 2014 were randomly divided into observation group （82 cases） and control group （74 cases）. The two groups were both treated with DC-CIK, and the observation group was additionally treated with ultrasound-guided per-cutaneous radiofrequency ablation for 6 weeks. The quality of life was assessed and compared before and after treat-ment by Core quality of life questionnaire （QLQ-C30）. Adverse reactions were recorded, and the short-term and long-term clinical efficacy was assessed. Results After treatment, the overall function, indexes of specific symptom module, overall QLQ-C30 scores were significantly better than those before treatment in the two groups （P〈0.05）, and all the above scores after treatment in the observation group were significantly better than those in the control group （P〉0.05）. The two groups all showed fever, chills combined with fever, rash, with no statistically significant differenc-es （P〉0.05）, and the observation group showed abdominal pain, nausea and vomiting, peripheral hepatic hematoma af-ter operation. After treatment, the two groups showed no statistically significant differences in short-term clinical effi-cacy （P〈0.05）, but the observation group was found to had significantly better long-term clinical efficacy and longer median survival time （P〈0.05）. Conclusion Radiofrequency ablation combined with DC-CIK can raise the long-term clinical efficiency and improve the quality of life of patients with advanced hepatocellular caicinoma.

关 键 词：中晚期肝细胞癌 射频消融术 临床疗效 生命质量 

分 类 号：R735.7[医药卫生—肿瘤]