经动脉化疗栓塞联合伽玛刀治疗原发性肝癌的疗效评价

Evaluation of TACE combined with gamma-knife radiotherapy for primary hepatocellular carcinoma

目的评估经皮动脉化疗栓塞(TACE)联合伽玛刀治疗原发性肝癌的近期临床疗效。方法 259例原发性肝癌患者,随机分成A、B两组,A组(联合治疗组)135例采用TACE+伽玛刀治疗,B组(对照组)124例采用TACE治疗。完成治疗3个月后复查肿瘤大小,所有病例随访2年。结果 259例患者全部完成治疗,A、B两组总有效率(CR+PR)分别为83.7%、50.8%;6、12、18、24个月的生存率分别为96.2%、85.9%、71.2%、54.1%和82.3%、65.3%、524%、33.1%,差异有统计学意义;不良反应无明显差异。结论 TACE联合伽玛刀治疗原发性肝癌有较好的近期效果,优于单纯介入治疗,远期疗效尚待进一步观察。

Objective To evaluate the therapeutic effect of transcatheter arterial chemoembolization （TACE） combined with gamma-knife radiotherapy in treating primary hepatocellular carcinoma. Methods A total of 259 patients with advanced primary hepatocellular carcinoma were enrolled in this study. The patients were randomly divided into study group （n = 135） and control group （n = 124）. The patients in study groupreceived TACE together with gamma-knife radiotherapy, while patients in control group received TACE only. Three months after the treatment, the lesion＇s size wasmeasured. All patients were followed up for 24 months. Results The scheduled treatment plan was completed in all patients. The total effective rate （CR ＋ PR） of the study group and the control group was 83.7% and 50.8%, respectively. The survival rate of 6, 12, 18 and 24 months for the study group was 96.2%, 85.9%, 71.2% and 54.1%, respectively, while for the control group the survival rate of 6, 12, 18 and 24 months was 82.3%, 65.3%, 52.4% and 33.1%, respectively. Significant difference in the survival rate existed between the two groups. No obvious difference in the incidence of adverse effect was found between the two groups. Conclusion TACE combined with gamma-knife radiotherapy has excellent short-term effect for primary hepatocellular carcinoma. This technique is superior to simple TACE in treating advanced hepatocellular carcinoma, although its long-term effect needs to be further studied.