经导管肝动脉化疗栓塞联合CT引导下经皮乙酸注射治疗原发性巨块型肝癌的疗效分析

Efficiency analysis of transcatheter arterial chemoembolization combined with CT-guided percutaneous acetic acid injection for huge hepatocellular carcinoma

目的探讨经导管肝动脉化疗栓塞（TACE）联合CT引导下经皮乙酸注射（PAI）治疗巨块型肝癌的临床应用价值。方法43例原发性巨块型肝癌患者随机分为两组，对A组21例行常规TACE治疗，于首次TACE治疗后，每间隔1个月重复治疗1次，共3次为一疗程；对B组22例行TACE联合PAI治疗，于首次TACE后2～3周在CT引导下行PAI治疗，每周1次，共6～9次为一个疗程。随访两组患者生存情况，并监测血清AFP，观察疗效。随访过程中若肿瘤复发，重复上述治疗一个疗程。结果治疗完成后1个月，两组AFP阳性率差异无统计学意义；单纯TACE、TAcE＋PAI治疗有效率分别为38．10％和77．27％，差异有统计学意义。A组1、2、3年生存率分别为47．62％、23．81％、9．52％，B组分别为81.82％、54．55％、36．36％，差异均有统计学意义。结论TACE联合PAI治疗巨块型肝癌疗效优于单纯TACE。

Objective To explore the clinical application value of transcatheter arterial chemoembolization （TACE） combined with CT guided percutaneous acetic acid injection （PAI） in treatment of huge hepatocellular carcinoma （HCC）. Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A un- derwent routine one course for TACE （three times）, and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2--3 weeks after first TACE, and one course included 6--9 times of PAL Postoperative follow-up was conducted （including AFP, the size of tumor, etc. ）. One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups （38.10% vs 77.27%）. The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.