局部内放疗预防肝癌切除术后复发的研究

Preventive effects of regional internal radiotherapy on recurrence of hepatocellular carcinoma after resection

目的了解肝内局部^32P玻璃微球（^32P-GMS）埋置对肝癌切除术后预防复发的效果。方法A组29位肝细胞性肝癌病人于肿瘤切除后局部埋置^32P-GMS，B组为同期38位肝癌病人行肝癌切除术后未埋置^32P-GMS。观察术后不同时间肝、血和尿中的放射性分布。随访统计两组病人的复发率和生存率。结果肝内局部埋置^32P-GMS的病人未发现血和尿中放射性分布。A组术后半年、1年、2年、3年及3年以上的复发率明显低于B组，存活率明显高于B组，具有统计学意义。两组手术死亡率及术后并发症发生率无明显差异。结论肝癌切除术后局部埋置^32P-GMS可以减少复发，延长病人的生存时间。

Objective To study the preventive effects of implantation of phosphorus-32 glass microspheres （^32 P-GMS） on postoperative recurrence of hepatocellular carcinoma （HCC）. Methods Twenty-nine patients with HCC were treated with implantation of ^32 P-GMS in the liver after removal of the tumor （group A） while other 38 did not receive the treatment after tumor removal （group B）. Results ^32 P-GMS implanted into the liver incision was not absorbed in blood but excreted by urine. The 1/2-, 1-, 2-, 3- and over 3-year recurrent rates were significantly lower but the survival rate markedly higher in group A than in group B. There was no significant difference in occurring rate of postoperative complications between the 2 groups. Conclusions The regional radiotherapy using implantation of ^32 P-GMS into the liver incision after HCC resection can prevent the recurrence of HCC and increase the survival time of the patients.