射波刀联合热疗及替吉奥治疗原发性肝癌复发转移的疗效观察

Clinical Observation of Cyberknife Therapy Combined with Hyperthermia and Tegafur for Treatment of Recurrent and Metastatic Hepatocellular Carcinoma

目的观察射波刀联合热疗及替吉奥治疗原发性肝癌复发转移的临床疗效及安全性。方法选择2013-01/2015-01月在作者医院治疗的84例原发性肝癌治疗结束后复发转移患者,按不同治疗方案分为对照组和观察组。对照组43例行射波刀联合热疗,观察组41例行射波刀联合热疗及替吉奥治疗。结果治疗后3个月总有效率为79.76%,观察组的有效率,1年、2年局部控制率分别为87.80%、60.00%、35.00%,均高于对照组的72.09%、46.34%、24.39%,但组间比较差异无统计学意义(P>0.05)。对照组的1年、3年生存率和中位生存期分别为46.34%、7.32%、10.5个月,观察组的1年、3年生存率和中位生存期分别为65.00%、17.50%、13.5个月,组间比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论射波刀联合热疗及替吉奥是治疗原发性肝癌复发转移的一种既安全又有效的方法。

Objective To evaluate the efficacy and toxicity of cyberknife therapy combined hyperthermia with tega- fur for treatment of recurrent and metastatic hepatocellular carcinoma. Methods From January 2013 to January 2015,84 patients with recurrent and metastatic hepatocellular carcinoma, in accordance with different therapeutic methods, were divided into control group and observation group. Forty-three patients in control group were treated with cyberknife therapy and hyperthermia, while forty-one patients in observation group used cyberknife combined hyperthermia with tegafur. Results Total efficacy rate after a three-month treatment was 79. 76%. The efficiency rate, 1- and 2-year local control rate in observation group were 87. 80%, 60. 00%, 35.00% ,and all higher than 72. 09%, 46. 34% and 24. 39% in control group. No significant differences were found between two groups （P〉0. 05）. One- and three-year survival rate in control group were separately 46. 34% and 7. 32% with the median survival of 10. 5 months. Oneand three-year survival rate in observation group were separately 65. 00% and 17. 5% with the median survival of 13. 5 months（P〈0. 05）. The adverse reaction rates in two groups were not significantly different （P〉0.05）. Conclusion The combination of eyberknife therapy with hyperthermia and tegafur is a safe and useful method in treatment of recurrent and metastatic hepatocellular carcinoma.