CT引导下射频消融联合^(125)I粒子治疗中晚期原发性肝癌的临床研究

Clinical value of CT-guided radioactive seeds ^(125)I implantation and radiofrequency ablation(RFA) in the treatment of Ⅲ-Ⅳ primary hepatic carcinoma

目的探讨射频消融(RFA)联合放射性125I粒子植入治疗中晚期原发性肝癌的疗效。方法 16例不能手术的乏血供肝癌患者行CT定位引导下行射频消融联合放射性125I治疗,125I粒子组织间植入前用计算机三维治疗计划系统(TPS)制定其粒子治疗计划,术后用TPS验证。2个月后复查肝脏增强CT了解肿块大小及坏死范围,评价临床疗效。结果 16例中CR 9例,PR 5例,NC 1例,PD 1例,总有效率87.50%(14/16)。中位生存期17月,1年生存率81.25%。结论射频消融联合125I粒子组织间植入治疗中晚期原发性肝癌疗效显著,创伤小,并发症低。

【Objective】To investigate the clinical efficacy of CT-guided radioactive seeds125 I implantation and radiofrequency ablation（RFA） in the treatment of Ⅲ-Ⅳ primary hepatic carcinoma. 【Methods】16 patients with unsectable hypovascular primary hepatic carcinoma received CT-guided radioactive seed125 I implantation and radiofrequency ablation（RFA） sequentially. CT-guided radioactive seeds125 I implantation was accepted and verified according to treatment planning system（TPS）. The therapeutic effects（the size of tumor and the extent of fibroid necrosis） were evaluated by Enhanced-CT in 2 months. 【Results】Among 16 cases, 9 obtained CR, 5PR, 1NC and 1PD,with total response rate of 87.50%（14/16）, median survival time is 17 months and one year survival rate achieved81.25%. 【Conclusions】CT-guided radioactive seeds125 I implantation RFA in the treatment of Ⅲ-Ⅳ primary hepatic carcinoma is an effective,microinvasive method with few complications.