经皮肝动脉碘油化疗栓塞联合CT引导下^125I放射性粒子植入治疗巨块型肝癌

Percutaneous transcatheter hepatic artery lipiodol chemoembolization combined with CT guided 125I radioactive particle implantation in treatment of huge hepatocellular carcinoma

目的：探讨经皮肝动脉碘油化疗栓塞（ TACE）联合CT引导下^125I 放射性粒子植入治疗巨块型肝癌的临床疗效及安全性。方法：将60例来我院就诊的巨块型肝癌患者随机分为2组,在基础治疗和常规检测下,对照组只行TACE,即经肝动脉对病变部位的供血组织用含有化疗药物的超液碘化油进行血管栓塞法治疗；观察组则先行TACE,再以TPS为依据得出所需^125I粒子数目,佐以CT引导,植入^125I粒子,术后复诊时间为1次/月,随访半年；以术后肿瘤大小缓解情况为指标评价疗效,并以相关并发症、复发例数等为观察指标,对比2组不良反应情况。结果：对照组与观察组患者术后总有效率分别为40%（12/30）、76.67%（23/30）,经比较,观察组疗效优于对照组（P〈0.05）；观察组患者中只有1例伴有呕吐症状,复查时发现1例肝癌复发患者,经比较,观察组术后不良反应例数明显低于与对照组（P〈0.05）。结论：使用经皮肝动脉TACE联合CT引导下^125I放射性粒子植入法治疗肝癌效果良好,明显优于单一TACE治疗法,不良反应少,值得推广。

Objective：To study the clinical efficacy and safety of the combination of percutaneous hepatic arterial lipiodol chemoembolization （ TACE） with CT guided ^125I radioactive particles implantation in the treatment of massive hepatocellular carcinoma. Methods：60 cases of huge hepatocellular carcinoma patients were randomly divided into two groups, based on treatment and conventional detection. The control group was treated with TACE only. The observation group received TACE treatment, and then was treated with CT guided 125I particle implantation. postoperative follow-up was 1 times per month for half a year. The size of the tumor remission were used to evaluate the postoperative effects. And the related complications, recurrence rate were used as observation index to compare the two groups. Results： The total efficiency of the control group and the observation group were 40% （ 12/30） and 76. 67% （23/30） respectively. The outcome of the observation group was better than the control group （P 〈 0. 05）. There were 1 case accompanied by vomiting, 1 case of recurrence in the observation group. The adverse reactions were lower in the observation group than in the control group （P 〈 0. 05）. Conclusion： The use of Percutaneous Transhepatic Artery TACE combined with CT guided 125I radioactive particles implantation for the hepatic carcinoma might be good and effective, and should be superior to the single TACE treatment. And so it should be worthy promoting.