肝癌动脉化疗栓塞后残留病灶的介入治疗

Interventional Therapy of Residual Lesions after Transarterial Chemoembolization in Patients with Primary Hepatic Carcinoma

目的探讨肝癌经动脉化疗栓塞(TACE)后残留病灶的经皮冷消融或放射性碘粒子植入治疗的可行性。方法搜集2007年1月-2009年12月间失去手术时机的原发性肝癌患者,应用TACE治疗3周后,针对96例存在残留病灶者,59例采用经皮氩氦冷冻系统作消融处理(冷消融组),37例行125I粒子植入组织间内放射治疗(碘粒子组),观察随访两组患者的疗效及并发症情况。结果冷消融组、碘粒子组患者均收到临床症状好转、AFP下降、肿块缩小的效果,总有效率分别为91.5%与86.5%,6,12,24个月生存率分别为93.2%、72.9%、52.5%与91.9%、70.3%、48.7%,无致命并发症出现。结论原发性肝癌TACE术后残留病灶的患者,行经皮冷消融或放射性碘粒子植入治疗能收到较好效果。

Objective To investigate the effect of percutaneous cryoablation or 125I seeds implantation on the residual lesions after transarterial chemoembolization（TACE） in patients with primary hepatic carcinoma（PHC）.Methods From January 2007 to December 2009,96 patients were found remaining tumor mass in the liver after TACE,and among them 59 underwent the percutaneous cryoablation（cryoablation group）,37 underwent 125I seeds implantation（seeds group）.All cases were followed up for clinical curative effect and complications.Results In the 96 cases of PHC,the clinical symptoms were improved,AFP decreased and the tumor deflated after interventional treatment in both groups.The total response rate was 91.5% in cryoablation group and 86.5% in 125I seeds implantation group,respectively.The survival rate of 6,12 and 24 months was 93.2%,72.9%,52.5% in cryoablation group,and 91.9%,70.3%,48.7% in 125I seeds implantation group,respectively.There were no severe complications.Conclusion For the remaining tumor mass of patients with PHC after TACE,percutaneous cryoablation or 125I seeds implantation can offers a safe and effective treatment options and improve their long-term survival.