氩氦刀冷冻消融联合TACE治疗巨大肝癌的临床观察

Clinical observation of argon-helium knife cryotherapy combined with transcatheter arterial chemoembolization( TACE) on huge liver cancer

目的探讨氩氦刀冷冻消融联合经肝动脉化疗栓塞（TACE）治疗巨大肝癌的有效性和安全性。方法回顾性分析本院2006年9月至2011年8月收治的巨大肝癌患者85例,其中观察组44例先行1～2次TACE,1个月后序贯氩氦刀治疗1～3次,而对照组41例仅行单纯TACE治疗。按照实体瘤的疗效评价标准（RECIST）1.0版评价疗效并随访生存。结果观察组有效率（RR）为70.5%,高于对照组的46.3%（P〈0.05）;观察组1、2和3年生存率分别为77.3%、56.8%和36.4%,中位生存时间为19.2个月,均高于对照组的51.2%、36.6%、14.6%和11.8个月（P〈0.05）;两组患者的不良反应均为轻中度且可耐受。结论氩氦刀联合TACE治疗具有互补增效作用,且安全微创,为巨大肝癌的综合治疗提供了新的途径。

Objective To explore the efficacy and safety of argonhelium knife cryotherapy combined with transcatheter arterial chemoembolization （ TACE） on huge hepatocellular carcinoma. Methods Eightyfive patients with huge liver cancer from September 2006 to August 2011 were analyzed retrospectively. Observation group （ n=44） received one to two TACE and one to three argonhelium knife cryotherapy after one month sequently, while the control group （ n=41） received TACE treatment only. Response to chemotherapy was assessed by RECIST criteria 1. 0 and followup data was investigated. Results The response rate of observation group was 70. 5%, higher than 46. 3% of the control group （P〈0. 05）. The 1, 2, 3year survival rates of observation group were 77. 3%, 56. 8% and 36. 4%, and medium overall survival time was 19. 2 months, which were all higher than the 51. 2%, 36. 6%, 14. 6% and 11. 8 months of control group （ P〈0. 05） . The adverse reaction of both groups were mildtomoderate and tolerable. Conclusion Argonhelium knife cryotherapy combined with TACE has synergism effect and minimally invasive, and provide a new regiem for comprehensive treatment on huge hepatocellular carcinoma.