经肝动脉栓塞化疗联合陀螺刀治疗原发性肝癌的临床疗效

Efficacy of transcatheter arterial chemoembolization combined with Gyro Knife in the treatment of primary liver cancer

目的观察经肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)联合陀螺旋转式60Co放射治疗系统(以下简称陀螺刀)治疗原发性肝癌的疗效。方法选择2008年6月至2011年1月本院收治的原发性肝癌患者71例,按不同治疗方法分为TACE治疗组35例及TACE联合陀螺刀治疗(联合治疗组)36例,比较两组患者的治疗效果。结果联合治疗组的有效率为77.8%,明显高于TACE治疗组的54.3%,差异有统计学意义(P<0.05)。联合治疗组和TACE治疗组的6个月、12个月、18个月、24个月生存率分别为97.2%、83.8%、52.8%、41.7%和71.4%、51.4%、34.3%、28.6%,差异均有统计学意义(P均<0.05)。联合治疗组行陀螺刀放疗过程中有3例(8.3%)发热,4例(11.1%)出现肝功能损害,均未发生骨髓抑制及放射性肺炎。结论 TACE联合陀螺刀治疗原发性肝癌的疗效优于单纯TACE治疗,可提高患者的生存率,毒副反应较少,值得临床推广应用。

Objective To observe the effect of transcatheter arterial chemoembolization （TACE） combined with cobalt-60 gyro rotating radiation （Gyro Knife） in the treatment of primary liver cancer. Methods Retrospective analysis was performed of 71 patients with primary liver cancer who were treated at our hospital from June 2008 to January 2011 using either TACE alone （n=35） or TACE combined with Gyro Knife （n=36）. Response and survival rates were compared for the two treatments. Results Combination therapy gave a significantly higher response rate （77.8%） than TACE alone （54.3%,P〈0.05）. Survival rates were significantly higher in the combination therapy group at various time points：97.2% vs 71.4% at 6 months,83.8% vs 51.4% at 12 months,52.8% vs 34.3% at 18 months, and 41.7% vs 28.6% at 24 months （all P〈0.05）. Among the combination therapy group three patients experienced fever and four experienced hepatic toxicity when received gyro knife radiotherapy,no cases of radiation pneumonia or bone marrow suppression were observed in either group. Conclusion TACE combined with Gyro Knife therapy may be safe and effective for treating primary liver cancer.