氩氦刀联合栓塞化疗治疗中晚期肝癌的临床研究

Cryotherapy combined with chemoembolization for the treatment of advanced hepatic carcinoma:a clinical study

目的探讨氩氦刀冷冻消融联合肝动脉栓塞化疗(TACE)治疗中晚期肝癌的方法、疗效及临床意义。方法将符合入选的192例中晚期肝癌患者分为单纯TACE组和氩氦刀联合TACE组(联合组),比较两组在治疗前后AFP、肿瘤复发率及生存期情况。结果单纯TACE组肿瘤完全坏死率为29%,联合组为88.04%;单纯TACE组肿瘤复发率为(42/100),联合组肿瘤复发率为(11/92);单纯TACE组血清AFP下降的程度明显低于联合组;通过30个月的随访可见各个时期的联合组生存率都要高于单纯TACE组。结论氩氦刀冷冻联合TACE治疗原发性肝癌是安全、有效的方法,效果明显优于单纯TACE。

Objective To discuss the technique, efficacy and clinical significance of cryoablation combined with transcatheter arterial chemoembolization （TACE） for the treatment of advanced hepatic carcinoma. Methods One hundred and ninety-two patients, who accorded with the selected criterion, were divided into TACE group （n = 100） and combination group （cryotherapy combined with TACE, n=92）. Pre- and post-treatment AFP level, recurrence rate and life span between two groups were compared. Results The complete necrosis rate of the tumor and the recurrence rate in TACE group were 29% and 42%, which were 88.04% and 24% in combination group, respectively. The serum AFP level was significantly decreased after treatment in both groups （P 〈 0.05 ）, and the reduction in AFP level was significantly greater in combination group than that in TACE group （P 〈 0.05）. During a follow-up of 30 months the survival rate at each evaluation period of combination group was higher than that of TACE group without exception. Conclusion As an effective and safe technique, cryoablation combined with chemoembolization is far superior to simple TACE in treating advanced hepatic carcinoma. （J Intervent Radiol, 2009, 18： 733-736）