肝动脉化疗栓塞联合经皮氩氦冷冻及无水乙醇注射治疗肝癌的临床研究

Clinical Trial Report of TACE Combined with PLCT and PEIT in Treatment of Liver Cancer

目的联合肝动脉栓塞化疗(transarterial chemoembolization,TACE)、经皮局部氩氦刀消融(percutaneous local cryotherapy,PLCT)和经皮瘤内无水乙醇注射治疗(percutaneous ethanol injectiontherapy,PEIT)三种微创方法综合治疗失去手术机会的肝癌,并与TACE单纯联合PEIT治疗相比较,观察其疗效和安全性。方法132例巨块型或结节型原发性肝癌入选,76例接受TACE、PLCT、PEIT三种微创治疗(三联组),56例接受TACE及PEIT两种微创方法治疗(两联组)。结果三联组和两联组之间的有效率(42.1%和17.9%)、临床获益率(85.5%和69.6%)、中位疾病进展时间(12周和10周)比较有统计学差异(P<0.05),1年生存率(75.0%和60.7%)比较无统计学差异(P>0.05)。结论TACE联合PLCT及PEIT比单纯联合PEIT治疗,明显提高了有效率和临床获益率,并延长了中位疾病进展时间,是一种合理、安全、有效的综合治疗模式。

Objective To assess the safety and effect of transarterial chemoembolization（TACE）,associated with percutaneous local cryotherapy（PLCT）and percutaneous ethanol injection therapy（PEIT） in treating unresectable liver malignance,and compared with TACE combined with PEIT alone.Methods One hundred and thirty-two patients with unresectable HCC were enrolled in this study.Seventy-six patients underwent TACE associated with PLCT and PEIT（triple-modality group）,56 patients underwent TACE associated with PEIT alone（bi-modality group）.Results Response rate（RR）（42.1% vs 17.9%）,Clinical benefited rate（85.5% vs.69.6%） and Time to progress（TTP）（12w vs.10w） between triple-modality and bi-modality group were statistically significant（P〈0.05）.1-year survival rate was no significant difference（P〉0.05）.Conclusion TACE combined with PLCT and PEIT is more effective than TACE combined PEIT alone,is a rational safe and effective multi-modality treatment model for unresectable HCC and worth further attention.