氩氦刀治疗结直肠癌肝转移临床获益分析

Analysis on clinical benefit induced by cryosurgery for patients with colorectal liver metastases

目的评估氩氦刀治疗不适合再次手术切除结直肠癌肝转移患者的临床获益。方法 68例患者随机分为A、B两组,比较应用氩氦刀组(A组)与未用组(B组)在2年生存率、瘤负荷减小和生活质量等方面的差别。结果用氩氦刀组与未用组相比两年生存率分别为71.88%和51.61%,血清CEA降至正常分别为57.14%和22.22%,病灶坏死或缩小分别为62.5%和22.6%,差异均有显著意义(P值分别为0.048、0.049和0.002)。结论氩氦刀治疗大肠癌肝转移瘤是一种微创、相对安全、疗效可靠的新方法,对于失去外科手术治疗机会的晚期结直肠癌肝转移患者氩氦刀联合化疗是一种有效的综合治疗模式。

Objective To assess the clinical benefit of cryosurgery for patients with colorectal liver metastases who were not suitable for re-resection. Methods Six-eight patients with liver metastases following surgical resection of colorectal cancer were divided into Group A（ with cry- osurgery） and Group B（without cryosurgery）. The differences of 2-year survival, reduction of tumor load, and quality of life between two groups were compared. Results The 2-year sur- vival rate, Changes in serum CEA value and necrosis or volume reduction of lesion for group A and group B were 71.88% vs 51.61%, 57.14% vs 22.22%, and 62.5% vs 22.6%, re- spectively. The difference was significant, and P values were 0. 048, 0. 049, and 0. 002, re- spectively. Conclusion Cryosurgery is a new reliable minimally-invasive and relatively-safe method for treating colorectal liver metastases. As for patients with liver metastases of advanced colorectal cancer who have no chances of surgery, cryosurgery in combination with chemothera-py is an effective, comprehensive treatment modality.