^(125)I粒子联合肝动脉化疗栓塞对原发性肝癌的疗效研究分析

Efficacy of ^(125)I Particles Combined with Transcatheter Arterial Chemoembolization in Primary Liver Cancer

目的探讨^(125)I粒子联合肝动脉化疗栓塞对原发性肝癌的治疗效果。方法选取2009年9月至2015年10月在我院收治的70例原发性肝癌患者,按随机分组法将患者分为观察组和对照组,每组各35例。对照组单纯采用TACE法治疗,观察组采用TACE联合^(125)I放射性粒子植入治疗组。治疗后的1、2、3月检测两组患者的血常规、肝功能、肿瘤体积的变化及患者肿瘤标志物(AFP)水平变化情况,并对两组患者进行疗效评价。结果治疗后,观察组有效率(RR)为85.7%,临床总控制率(CR+PR+SD)为94.3%,对照组有效率(RR)为66.7%,临床总控制率(CR+PR+SD)为71.4%,观察组的疗效明显优于对照组,差异有统计学意义(P<0.05)。在AFP阳性患者中,观察组AFP减小率(转阴率+降低率)显著高于TACE对照组组(P<0.05),差异有统计学意义。两组患者的术后并发症差异无统计学意义。结论^(125)I放射性粒子植入联合TACE治疗原发性肝癌疗效确切,安全可靠,不仅改善了患者的生存质量,提高了患者的生存期,还抑制了肿瘤的复发,值得在临床推广和应用。

Objective To investigate the efficacy of 1251 particles combined chemoembolization （TACE） in primary liver cancer. Methods We enrolled 70 with transcatheter arterial patients with primary liver cancer who were treated in our hospital from September 2009 to October 2015. The patients were randomly divided into observation group and control group, 35 cases in each group. Patients in control group were treated with TACE treatment, the observation group with TACE combined with 1251 seed implantation in the treatment group. Blood routine, liver function, tumor volume and changes in patients with tumor markers （AFP） levels were detected in each group one, two and three months post treatment. The efficacy evaluation was performed. Results After treatment, the observation group （RR） efficiency was 85. 7%, the total clinical control rate （ CR ＋ PR ＋ SD ） was 94.3 %, control group （RR） efficiency was 66.7 %, the total clinical control rate was 71.4% in the observation group, the curative effect is obviously superior to the control group, the difference is statistically significant （P 〈 0. 05 ）. In AFP positive patients the AFP reduction rate （ negative rate reduced rate） of observed group was significantly higher than that of the control group （ P 〈 0. 05 ）, the difference was statistically significant. There was no significant difference in postoperative complications between the two groups. Conclusion 1251 radioactive seed implantation combined with TACE in the treatment of primary liver cancer is an accruate, safe and reliable treatment. It can not only improve the quality of life and the survival of patients, but also inhibit the recurrence of tumors. It is worthy of clinical promotion and application.