体外局部高频热疗联合放疗治疗进展期肝细胞癌患者临床疗效研究  

Clinical observation of external local high frequency thermotherapy and radiotherapy in the treatment of patients with advanced hepatocellular carcinoma

作　　者：李曼[1] 李静[3] 陈文玲[1] 陈永利[2] 王力军[1] Li Man;Li Jing;Chen Wenling(Department of Radiotherapy and Chemotherapy,Second Affiliated Hospital,Xingtai Medical College,Xingtai 054000,Hebei Province,China)

机构地区：[1]邢台医学高等专科学校第二附属医院放化疗科,河北省邢台市054000 [2]邢台医学高等专科学校第二附属医院普外科,河北省邢台市054000 [3]河北医科大学附属第四医院放疗科

出　　处：《实用肝脏病杂志》2021年第2期256-259,共4页Journal of Practical Hepatology

基　　金：邢台市科技局科研计划项目(编号:2019ZC346)。

摘　　要：目的研究体外局部高频热疗辅助放疗治疗进展期肝细胞癌(HCC)患者的临床疗效。方法采用随机数字表法将66例进展期HCC患者分为对照组33例和观察组33例,分别采取放疗或在放疗的基础上联合体外局部高频热疗治疗,随访12个月。结果观察组客观缓解率(ORR)为63.6%,显著高于对照组的35.5%(P<0.05);治疗后,观察组血清甲胎蛋白异质体L3(AFP-L3)水平为(4.2±1.0)ng/ml,高尔基糖蛋白-73(GP73)水平为(55.1±2.6)ng/ml,血管内皮生长因子(VEGF)水平为(200.5±55.7)pg/ml,均显著低于对照组[分别为(5.9±0.9)ng/ml、(62.1±3.5)ng/ml和(265.7±60.3)pg/ml,P<0.05];观察组放射性肝损伤发生率为21.2%,显著低于对照组的45.2%(P<0.05);观察组中位总生存时间(OS)为8(95%CI:7~9)个月,1 a累积生存率为14.3%,对照组中位OS为6(95%CI:6~7)个月,1 a累积生存率为11.8%(x2=1.674,P=0.171)。结论采取体外局部高频热疗辅助放疗治疗进展期HCC患者有一定的临床疗效,可使生存获益,并能减轻放射性肝损伤。Objective The aim of this study was to investigate the clinical efficacy of external local high frequency thermotherapy(ELHFT)and radiotherapy in the treatment of patients with advanced hepatocellular carcinoma(HCC).Methods 66 patients with advanced HCC were enrolled in this study,and were randomly divided into control and observation group,with 33 cases in each group.The patients in the control received three-dimensional conformal therapy/intensity modulated radiation therapy(3D-CRT/IMRT),and those in the observation received ELHFT and 3D-CRT/IMRT.All patients were followed-up for 12 months.Results The objective remission rate in the observation group was 63.6%,significantly higher than 35.5%(P<0.05)in the control;after treatment,serum alpha-fetoprotein heterogeneity L3 level was(4.2±1.0)ng/ml,Golgi protein-73 level was(55.1±2.6)ng/ml,and vascular endothelial growth factor level was(200.5±55.7)pg/ml,all significantly lower than[(5.9±0.9)ng/ml,(62.1±3.5)ng/ml and(265.7±60.3)pg/ml,respectively,P<0.05]in the control;the incidence of radiationinduced liver injury in the observation was 21.2%,much lower than 45.2%(P<0.05)in the control;the median overall survival(OS)in the observation group was 8(95%CI:7-9)m,and the 1-year cumulative survival rate(CSR)was 14.3%,and the median OS in the control was 6(95%CI:6-7)m and the 1-year CSR was 11.8%(x2=1.674,P=0.171).Conclusion The ELHFT and radiotherapy might improve the survival in patients with advanced HCC,which needs further clinical investigation.

关 键 词：肝细胞癌 高频热疗 放疗 治疗 

分 类 号：R735.7[医药卫生—肿瘤]