微波消融、TACE与全身化疗治疗结直肠癌肝转移的疗效

Comparison of Prognosis of Patients with Liver Metastases of Colorectal Cancer Treated by Micro- wave Ablation, Transhepatic Arterial Chemotherapy and Embolization and Systemic Chemotherapy

【目的】探讨微波消融、介入栓塞化疗（TACE）序贯方案与全身化疗治疗结直肠癌肝转移的临床疗效。【方法】根据不同治疗方案将80例结直肠癌肝转移患者分为观察组（全身化疗＋微波消融＋TACE序贯治疗）与对照组（全身化疗），比较两组近期疗效，预后及治疗前后细胞免疫功能变化。【结果】观察组近期客观有效率为66．67％（28／42），高于对照组的42．10％（16／38），且差异有显著性（P〈0．05）；观察组首次治疗后CD^3＋、CD4^＋阳性率、CD4^＋／CD8^＋比值均显著大于，CD86＋显著小于同组治疗前、对照组治疗后（均P〈0．05）；观察组中位存活时间26．00个月长于对照组的13．60个月（P〈0．05）。【结论】在全身化疗基础上，行微波消融＋TACE治疗能显著提高结直肠癌肝转移患者的有效率，明显改善机体免疫功能，延长患者存活时间。

[Objective]To compare the prognosis of patients with liver metastases of colorectal cancer treated by mi crowave ablation, transhepatic arterial chemotherapy and embolization （TACE） and systemic chemotherapy. [Methods] According to different treatment methods, 80 eases of patients with liver metastases of eoloreetal cancer were divided into the observation group （treated by microwave ablation-J-TACE sequential therapy） and the control group （treated by systemic chemotherapy）. The short-term curative effect and prognosis （survival） were compared between the two groups, and the changes of cell immune function before and after treatment were determined and recorded. [ResuhslThe short- term obiective response rate （ORR） of the observation group was 66.67 % （28/42）while that of the control group was 42.10%（16/38）, and the difference was significant （ P 〈0.05）. After initial treatment, positive rate of CD3^＋ , CD^＋ and the ratio CD4^＋/CD8^＋ were significantly higher, and CD8n was significantly lower in the observation group tban those in the same group before treatment and those in the control group after treatment （ P 〈0.05）. The median survival time of the observation group was 26.00 months while that of the control group was 13.60 months （ P 〈0.05）. [Conclusion]On the basis of systemic chemotherapy , microwave ablation -- TACE can significantly improve the effective rate of significantly improve the immune function and prolong