TACE联合^(125)碘粒子植入治疗原发性肝癌的疗效观察

Therapeutic efficacy of TACE combinde with ^(125)I seed implantation and TACE combined with ^(125)I seed implantation and Intra-tumor injection of in the treatment of hepatic carcinoma

目的探讨经皮导管动脉化疗栓塞术(TACE)联合CT导向下125碘粒子植入与TACE联合125碘粒子植入联合顺铂瘤内注射治疗肝癌的疗效。方法选择100例原发肝癌患者,随机分成2组,50例TACE+125碘粒子植入术为对照组,与治疗组50例TACE+125碘粒子植入+顺铂瘤内注射术,术后行肿瘤体积、血AFP值、T淋巴细胞亚群CD3、CD4、CD8,血常规、肝肾功能指标、种植性转移、随访生存期对比。结果所有患者均于术后1、2、6、12个月后复查,结果显示对照组50例肿瘤体积平均缩小27.4%,治疗组肿瘤体积平均缩小38.6%;两组血AFP值均下降,治疗组下降明显;对照组发现7例远处转移,治疗组3例远处转移;肝肾功能及T淋巴细胞亚群检测,对照组与治疗组无显著差异;术后一年死于远处转移者,对照组8例,治疗组2例,对照组与治疗组对比差异有统计学意义(P<0.05)。结论 TACE+125碘粒子植入+顺铂瘤内注射治疗肝癌的疗效观察证明,TACE联合粒子植入及顺铂瘤内注射治疗肝癌较TACE联合粒子植入方法治疗更为有效。

Objective To compare the therapeutic efficacy of transcatheter arterial chemoembotization（TACE） combined with either^ 125I seed implantation or ^125I seed implantation and Intra-tumor injection of Cisplatin for treating hepatic carcinoma （HCC）. Methods Total of 100 patients with HCC were analyzed. The control group （50 cases） received TACE combined with ^125I seed implantation therapy and the therapy group（50 cases） were treated with Intra-tumor injection of Cisplatin combined with TACE combined with ^125I seed implantation therapy. After treatment, blood routine, liver and kidney function, tumor volume, T lymphocyte subsets changed CD3 CD4 and CD8, implanted metastases and survival were studied. Results Tumor volume was decreased on average by 27.4% in the control group and 38.6% in the therapy group; AFP was decreased in all cases, and it was significantly lower in the therapy group than in the control group; remote metastasis were observed in 7 of the control group and 3 of the therapy group; No sig- nificant differences of blood routine, liver and kidney function, T-lymphocyte subsets were found between control group and therapy group ; At 1 year after treatment 8 patients died of metastases in control group and 3 in therapy group（P 〉 0. 05）. Conclusion TACE combined with either ^125I seed implantation or ^125I seed implantation and Intra-tumor injection of Cisplatin is effective for treating HCC. Of the two combination therapies,TACE combined with ^125 I seed implantation and Intra-tumor injection of Cisplatin is more effective for treating HCC.