复发性肝癌非手术治疗临床疗效比较

Comparison of clinical efficacy of non-surgical treatment for recurrent hepatocellular carcinoma

目的探讨复发性肝癌常用非手术治疗方法的临床疗效。方法回顾性分析2012年1月至2014年12月我院诊治的96例复发性肝癌患者的临床资料,其中,16例采用125I粒子植入治疗(A组),43例采用射频消融治疗(B组),37例采用肝动脉栓塞化疗(TACE)治疗(C组),观察3组患者治疗前后近期AFP及肝功能变化,再次治疗后生存时间,比较3组不同治疗方法疗效。结果治疗后3组患者AFP与治疗前比较差异具有统计学意义(P<0.05),而B组患者AFP低于A、C组(P<0.05),治疗后1、2周3组患者肝功能无明显差异(P>0.05);3组患者再次治疗后生存时间分别为(26.6±18.1)月、(25.3±8.4)月和(17.3±10.6)月(χ2=7.57,P<0.05),A、C组患者6、12、18月生存率分别为87.5%、68.75%、43.75%和81.08%、54.05%、45.95%,两者间差异无统计学意义,B组6、12、18月生存率分别为97.67%、81.39%、74.42%,显著高于A、C两组(P<0.05)。结论本研究中涉及的复发性肝癌常用的3种非手术治疗方法均有一定疗效,但3组比较中射频消融效果最好。因此,对于复发性肝癌的非手术治疗,应尽可能采用射频消融,而其他两种方法可作为射频消融的辅助措施,改善患者预后。

Objective To explore the non-surgical treatment for recurrent hepatocellular carcinoma and their clinical effect.Methods The clinical data of 96 cases of recurrent hepatocellular carcinoma in our hospital during the period from January 2012 to December 2014 were retrospectively analyzed.Among them,16 patients were treated with 125I（A group）,43 patients were treated with radiofrequency ablation（B group）,and 37 patients were treated with TACE（C group）.AFP and liver function changes of the three groups before and after treatment,and survival time after treatment were closely observed.The therapeutic effects of three groups of different treatments were compared.Results After treatment,recent AFP of the three groups of patients were significantly changed,and compared with that before treatment,the difference was statistically significant（P〈0.05）.AFP of group B patients was lower than that of group A and C（P 0.05）.After treatment,the liver function of three groups in one and two weeks had no obvious difference（P〈0.05）.The survival time of the three groups of patients after treatment was（26.6±18.1）months,（25.3±8.4）months and（17.3±10.6）months（χ2=7.57,P〈0.05）.The survival rate of group A and C in 6,12,18 months were 87.5%,68.75%,43.75% and 81.08%,54.05%,45.95%.There was no statistically significant difference between the two groups.The survival rates of group B in 6,12,18 months were 97.67%,81.39%and 74.42%,which was significantly higher than group A and C（P〈0.05）.Conclusion Three kinds of non-surgical treatment in the study for recurrent hepatocellular carcinoma were all effective,but the effect of radiofrequency ablation in three groups was the best.So the non-surgical treatment for recurrent hepatocellular carcinoma should be used as far as possible,and the other two methods can be used as an auxiliary measure to improve the prognosis of patients with recurrent hepatocellular carcinoma.