肝动脉介入栓塞化疗联合陀螺刀放疗治疗不能手术原发性肝癌108例的疗效分析  

Clinical research of transcatheter arterial chemoembolization combined with gyro knife radiotherapy in the treatment of 108 cases of inoperable primary hepatocellular carcinoma

作　　者：张为家 苏小岩 李爽[1] 曾海 ZHANG Weijia;SU Xiaoyan;LI Shuang;ZENG Hai(Department of Oncology,The First Affiliated Hospital of Yangtze University,Jingzhou,Hubei 434000,China;Department of Radiation and Medical Oncology,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,China)

机构地区：[1]长江大学附属第一医院肿瘤科,湖北荆州434000 [2]武汉大学第二临床学院肿瘤放化疗科,湖北武汉430071

出　　处：《安徽医药》2019年第6期1191-1194,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨肝动脉介入栓塞化疗(TACE)联合陀螺刀放疗治疗不能手术原发性肝癌的临床疗效和安全性。方法 2013年2月至2015年7月长江大学附属第一医院确诊的不能手术晚期原发性肝癌病人108例,采用随机数字表法分为单纯TACE组54例及TACE联合陀螺刀放疗组54例。观察两组近期疗效、无疾病进展生存时间(PFS)、总体生存时间(OS)、毒副反应及生存质量。结果 108例病人均按要求进行随访,两组近期疗效(61.11%比81.48%,Z=-2.684,P=0.007)、中位PFS (4个月比8个月,χ~2=8.276,P=0.015)和OS(12.5个月比21.0个月,χ~2=12.572,P=0.007)比较,联合治疗组均优于TACE组,均差异有统计学意义。两组在胃肠道反应、骨髓抑制、发热、肝功能损伤等方面比较差异无统计学意义(均P>0.05)。经治疗3个月后,联合治疗组Karnofsky评分明显优于TACE组(t=8.965,P=0.014)。结论 TACE联合陀螺刀放疗能提高不能手术原发性肝癌的近期疗效,延长病人的PFS和OS,毒副反应较少,可改善病人生存质量。Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with gyro knife in the treatment of unresectable primary hepatocellular carcinoma.Methods All 108 patients of unresectable primary hepatocellular carcinoma admitted to The First Affiliated Hospital of Yangtze University from February 2013 to July 2015 were randomly assigned into simple TACE therapy group(54 cases)and TACE combined with gyro knife radiotherapy group(54 cases).The short-term curative effects,progress free survival(PFS),overall survival(OS),toxicity and adverse reactions,and survival quality scores were observed in the two groups.Results All the 108 cases were followed up according to the requirements.The short-term efficacies(61.11%vs.81.48%,Z=-2.684,P=0.007),median PFS(4 months vs.8 months,χ^2=8.276,P=0.015)and OS(12.5 months vs.21.0 months,χ^2=12.572,P=0.007)in the combined treatment group were superior to the TACE group,and the differences were statistically significant.There were no significant differences in gastrointestinal reaction,myelosuppression,fever and hepatic insufficiency between the TACE group and the combined treatment group(all P>0.05).After 3 months of treatment,the Karnofsky score of the patients in the combined treatment group was significantly better than that in the TACE group(t=8.965,P=0.014).Conclusion TACE combined with gyro knife radiotherapy can improve the short-term curative effect of inoperable primary hepatocellular carcinoma,prolong PFS and OS,and reduce toxic and side effects,which can improve the quality of life of patients.

关 键 词：肝癌 陀螺刀放疗 经导管肝动脉化疗栓塞 钴 

分 类 号：R735.7[医药卫生—肿瘤]