CT引导下125Ⅰ粒子植入术联合肝动脉化疗栓塞治疗原发性肝癌疗效观察

Therapeutic effect of CT-guided 125Ⅰ seed implantation combined with TP chemotherapy in the treatment of primary hepatocellular carcinoma

目的观察CT引导下125Ⅰ粒子植入术联合肝动脉化疗栓塞治疗原发性肝癌(PHC)的临床疗效。方法选取我院72例PHC患者,按照治疗方法分组,各36例。化疗组采用肝动脉化疗栓塞治疗,联合组在化疗组基础上行CT引导下125Ⅰ粒子植入术治疗。对比2组治疗效果、不良反应发生率、治疗前、治疗后3个月血清癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、鳞状细胞癌相关抗原(SCC-Ag)、糖类抗原125(CA125)水平。结果联合组治疗后3个月总有效率86%(31/36)较化疗组61%(22/36)高(P<0.05);治疗后3个月观察组血清CEA、CYFRA21-1、SCC-Ag、CA125水平较对照组低(P<0.05);2组发热、恶心呕吐、骨髓抑制发生率对比,差异无统计学意义(P>0.05)。结论 CT引导下125Ⅰ粒子植入术联合肝动脉化疗栓塞治疗PHC患者,能增强治疗效果,降低血清CEA、CYFRA21-1、SCC-Ag、CA125水平,且不会明显增加不良反应,具有一定安全性。

Objective To observe the clinical efficacy of CT-guided 125Ⅰ seed implantation combined with paclitaxel + cisplatin(TP) chemotherapy in the treatment of Primary hepatocellular carcinoma(PHC). Methods Seventy-two patients with PHC in our hospital were selected and divided into 36 cases according to the treatment method.Hepatic arterial chemoembolization in the chemotherapy group, and the combined group was treated with CT-guided 125Ⅰ seed implantation. The therapeutic effect, incidence of adverse reactions, serum levels of carcinoembry-onic antigen(CEA), cytokeratin fragment 19(CYFRA21-1), squamous cell carcinoma associated antigen(SCC-Ag) and carbohydrate antigen 125(CA125) were compared between the two groups before and after treatment. Results The total effective rate of the combined group was 86%(31/36) higher than that of the chemotherapy group 61%(22/36)(P <0.05);the serum CEA, CYFRA21-1, SCC-Ag and CA125 levels of the observation group were lower than those of the control group(P<0.05). There was no significant difference in the incidence of fever, nausea and vomiting, and bone marrow suppression between the two groups(P>0.05). Conclusion CT-guided 125Ⅰ seed implantation com-bined with transcatheter arterial chemoembolization in the treatment of PHC patients can enhance the therapeutic effect, reduce the levels of serum CEA, CYFRA21-1, SCC-Ag, CA125, and do not significantly increase adverse reactions. It has certain safety.