γ-刀联合射频热疗治疗原发性肝癌TACE术后患者的疗效

The clinical efficacy of gamma knife combined with radio- frequency hyperthermia to the hepatic cell carcinoma( HCC) after transcatheter arterial chemoembolization( TACE)

目的：探讨伽马刀联合热疗对原发性肝癌肝动脉化疗栓塞术（TACE）后患者的临床疗效。方法：63例原发性肝癌患者均已行TACE术治疗,治疗后4周采用随机数字表分为治疗组（伽马刀联合热疗）和对照组（单纯伽马刀治疗）,两组在年龄、性别、卡氏评分等方面,差异无统计学差异（P〉0.05）。放疗为4000~6600cGy/20~33f,每次200cGy,热疗为每周2次,每次间隔72小时,8次/疗程,热疗于放疗结束后即进行,观察KPS评分、近期疗效、生存率及不良反应,随访时间截止2012年8月。结果：治疗组有效率（CR＋PR）70.59%（24/34）,局部控制率（CR＋PR＋SD）91.18%,治疗组0.5、1、2、3年生存率分别为88.23%、79.41%、41.17%、17.64%;对照组有效率58.62%（17/29）,局部控制率79.31%,对照组0.5、1、2、3年生存率分别为82.55%、62.06%、20.69%、6.90%,经比较两组有效率有统计学差异（P〈0.05）,局部控制率无统计学差异（P〉0.05）,1、2、3年生存率有统计学差异（P〈0.05）。治疗组在KPS评分、AFP方面改善程度明显优于对照组,有统计学差异（P〈0.05）。结论：原发性肝癌TACE术后行伽马刀联合热疗较单纯放疗可显著提高患者近期临床缓解率,延长生存期,提高患者功能评分KPS,降低AFP程度,不增加不良反应。

Objective：To analyze the clinical efficacy of gamma knife combined with radio -frequency hyperthermia to the hepatic cell carcinoma （HCC） patients after transcatheter arterial chemoembolization （ TACE ）. Methods ： All 63 HCC patients treated with TACE ,4 weeks after treatment using a random number table were divided into treatment group （gamma knife combined with hyperthermia） and control group （gamma knife）. The difference of the two groups in age, gender, Karnofsky score, was not statistically significant （ P 〉 0.05 ） . /ladiotherapy using 4 000 6 600cGy/20 -33f,200cGy each time, hyperthermia twice a week, each time interval 72 horn＇s,8 times/treatment,hyperthermia carried on after the end of radiotherapy, to observe KPS, AFP, short - term effect, the survival rate and ad- verse reactions. Results：The effective rate of treatment group was （CR ＋ PR） 70.59% （24/34）, the local control rate （ CR ＋ PR ＋ SD） was 91.18%. Treatment group 0.5,1,2,3 - year survival rates were 88.23% ,79.41% ,41.17% , 17.64%. The effective rate of control group was 58.62% （17/29） ,the local control rate was 79.31%. Control group 0.5,1,2,3 - year survival rates were 82.55 % , 62.06% , 20.69 % , 6.90% （ P 〈 0.05 ）. 1,2,3 - year survival rates were significantly different （ P 〈 0.05 ）. Treatment group KPS, AFP was significantly better than the control group （ P 〈 0.05 ）. Conclusion： HCC patients after TACE treated with gamma knife combined with hyperthermia compared with radiotherapy alone can significantly improve patients＇shortterm clinical remission rate and prolong survival, improve KPS score,AFP levels without increasing adverse reactions.