肝动脉栓塞和门静脉化疗配合放疗治疗肝癌

HEPATIC ARTERY EMBOLIZATION,PORTAL VEIN PERFUSION CHEMOTHERAPY AND RADIOTHERAPY FOR PRIMARY LIVER CANCER

将 8 2例不能切除的原发性肝癌 (简称肝癌 )患者随机分为 4组。Ⅰ组 2 0例 ,行肝动脉结扎加化疗栓塞。Ⅱ组 2 3例 ,行全肝移动条放射治疗。Ⅲ组 1 8例 ,在肝动脉结扎加化疗栓塞的同时行门静脉置入全埋入式药物输注装置 (简称化疗泵 ) ,术后行门静脉灌注化疗。Ⅳ组 2 1例 ,在Ⅲ组治疗方法的基础上加用全肝移动条照射治疗。全部病例均随访 1年以上。Ⅰ、Ⅱ、Ⅲ、Ⅳ组的 1年生存率分别为2 5 0 %、1 3 0 %、33 3%、和 6 1 9% ,以Ⅳ组疗效最好。提示肝动脉结扎加化疗栓塞和门静脉灌注化疗配合放疗是不能切除肝癌的较好治疗方法。

Eighty-two patients with unresectable primary hepatic carcinoma were divided randomly into 4 groups. Twenty patients (group A) were treated with hepatic artery ligation and embolization. Twenty-three patients (group B) were treated with whole liver moving strip irradiation. Eighteen (group C) were treated with hepatic artery ligation and embolization and portal vein perfusion chemotherapy. Twenty-one (group D) were treated with the therapy as the group C and the whole liver moving strip irradiation. All were followed-up to 12～37 months. The 1-year survival rates of these four groups were 25.0%(5/20), 13.0%(3/23), 33.3%(6/18) and 61.9%(13/21), respectively. The authors believe that combined treatment of group D is recommended for advanced and unresectable primary hepatic carcinoma.