热疗结合介入化疗栓塞术治疗中晚期肝癌的疗效观察

The clinical observation of hyperthermia and transcatheter arteria chemoembolization in the treatment of the advanced patients with hepatocellular carcinoma

目的观察热疗与介入化疗栓塞术联合治疗中晚期肝癌的临床疗效和毒副反应。方法选取原发性中晚期肝癌患者40例,分为两组,每组20例。治疗组行介入化疗栓塞加局部区域热疗。对照组仅行常规介入化疗加栓塞治疗。化疗方案采用阿霉素(ADM)50～60mg、丝裂霉素(MMC)6～8mg、顺铂(DDP)60～80mg、5氟尿嘧啶(5Fu)500mg。栓塞剂采用超液态碘化油及明胶海绵。结果治疗组总有效率75%(1520),对照组40%(820)(P<0.05)。两组0.5、1、1.5、2年生存率分别为100%,95%;90%,75%;65%,45%;60%,25%;治疗组0.5、1、1.5生存率较对照组无明显提高(P>0.05),2年生存率较对照组明显提高(P<0.05)。毒副反应无差异。结论热疗联合介入化疗栓塞术治疗中晚期肝癌疗效优于单纯介入化疗栓塞术,且不增加毒副作用,是治疗中晚期肝癌的一种安全有效的综合治疗方法。

Objective To evaluate the efficacy and side effects of hyperthermia and transcatheter arteria chemoembolization in the treatment of the advanced patients with hepatocellular carcinoma. Methods Fouty patients of advanced hepatocellular carcinoma were randomly divided into two groups, each group had 20 cases. The observed group was treated transcathctcr arterial chemoembolization in combination with hyperthermia, the control group with ordinary interventional chemotherapy and embolizing therapy. All patients received ADM 50-60 mg, MMC 6 - 8 mg, DDP 60 -80 mg, 5-Fu 500 mg. Super-liquid iodided oil and transperent sponges were used. Results The efficacy with the observed group and control group were 75 % （15/20） and 40% （8/20） respectively （P 〈 0.05）. The survival rates of both groups for 0.5, 1, 1.5 and 2 years were 100%, 95%; 90%, 75% ; 65%, 45% ; 60%, 25% respectively, there were no significant difference in the survival rate for 0.5,1, 1.5 years （ P 〉 0.05）, but difference was statistically signiticant for 2 years （ P 〈 0.05）. There were no significant difference in side effects for both groups. Conclusion The efficacy in the treatment of the advanced hepatocellular carcinoma with hyperthermia and transcatheter arteria chemoembolization is better than with ordinary interventional chemotherapy and embolizing therapy, and its side effects is not increased. This method is a safe and effective treatment.