摘要
目的探讨降低原发性肝癌切除术后局部复发的方法,提高肝癌患者的长期生存率。方法78例肿瘤靠近第一、第二肝门,估计切缘距肿瘤<1cm的肝癌患者,按就诊单双日分为单纯切除组和联合组。单纯切除组38例,仅行常规肝癌切除;联合组40例,在肝癌切除后,切缘行射频消融和^(125)I粒子植入。全部患者术后均定期随访。结果联合组术后1、3、5年肿瘤复发率分别为7.5%、30.0%和45.0%,术后1、3、5年生存率分别为92.5%、67.5%和30.0%,与单纯切除组比较,其中3、5年复发率差异有统计学意义((x^2=7.340,P<0.01;x^2=15.740,P<0.01);联合组的3、5年生存率较单纯切除组呈现明显升高的趋势。结论肝癌切除后切缘射频消融和^(125)I粒子植入能有效地降低术后局部复发率,提高治疗效果,且有可能延长肝癌患者的生存期。
Objective To evaluate the efficacy of intraoperative radiofrequency ablation and ^125I therapy for preventing local recurrence in hepatocellular carcinoma(HCC) after hepatectomy. Methods Seventyeight HCC patients with a tumor close to the first or the second hepatic portal underwent hepatectomy with a resection margin less than 1 cm from 1999 to 2001. All patients were randomly divided into control group and combined treatment group according to their check-in date (odd or even). In the control group, 38 patients were treated with hepatectomy alone, whereas in the combined group, 40 patients were treated with hepatectomy plus radiofrequency ablation and ^125I implantation on surgical margin. All patients were followed up regularly. Results the 1-, 3- and 5-year recurrent rate was 7.5%, 30.0% and 45.0% in the combined treatment group versus 18.4%, 60.5% and 86.8% in the control group, respectively, with a significant difference in the 3-year (X^2 =7. 340, P 〈0.01 ) and 5-year recurrent rates (X^2 = 15. 740,P 〈 0.01). The 1-,3- and 5-year survival rate was 92.5%, 67.5% and 30.0% in the combined group versus 81.5%, 39.4% and 18.4% , respectively. Conclusion Intraoperative radiofrequency ablation and ^125I therapy on the resection margin is effective to prevent local recurrence in HCC patients after hepatectomy, and to prolong their postoperative tumor free survival.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2007年第8期626-628,共3页
Chinese Journal of Oncology