微创医学

目的探讨肝动脉热灌注介入化疗栓塞术联合三维适形放疗(3D-CRT)及热疗治疗肝内多发肝癌的治疗效果。方法 53例原发性肝癌患者用抽签法随机分为治疗组和对照组,对照组给予常规的介入栓塞化疗(TACE)和三维适行放疗,治疗组在TACE时和放疗期间安排热介入治疗各一次,并在放疗期间每周安排2次体外高频热疗。结果治疗组生存期为13.7～44.3个月,中位生存期29个月,对照组生存期13.8～28.2个月,中位生存期21个月;至疾病进展时间(TTP)分别为261～541d(中位TTP:401d)和114～301 d(中位TTP:208d);1年及2年生存率治疗组为81.5%和51.9%,对照组为62.5%和20.8%。在统计学上均有显著性差异,两组间毒副反应无明显差异(P>0.05)。结论介入热灌注和体外高频热疗能提高TACE和3D-CRT治疗原发性肝癌的疗效,不增加并发症和毒副反应的发生。

Objective To research the effect of hyperthermia combined with three-dimensional conformal radiotherapy(3D-CRT) and transcatheter arterial thermo-chemoembolization(TATCE) for patients with intrahepatic hepatocellular carcinomas.Methods 53 patients with intrahepatic hepatocellular carcinomas were randomly divided into treatment group and control group,control group received TACE and three-dimensional conformal radiotherapy,treatment group received transcatheter hyperthermia treatment one time each in TACE and during three-dimensional conformal radiotherapy,and hyperthermia 2 times a week during radiation therapy.Results Treatment group survival was 26 to 42 months,the median survival was 34 months.The control group survival was 14 to 28 months,the median survival was 21 months.Time to progression(TTP) was 261-541 days(median TTP:401 days) and 114-301 days(median TTP:208 days),survival rate after 1,2 year in the treatment group was 77.8%,54.5% vs in the control group was 62.5%,20.8%,there were statistically significant difference.Toxicity between the two groups was no significant difference(P>0.05).Conclusion Thermo-chemotherapy and in vitro high frequency hyperthermia can enhance the effect of TACE and 3D-CRT on hepatocellular carcinoma,have not been added toxicity and side reactions.