125I粒子植入联合经导管肝动脉化疗栓塞、索拉菲尼治疗中晚期原发性肝癌的效果分析

Clinical Analysis of 125I Seed Implantation Combined with Transcatheter Arterial Chemoembolization and Sorafenib in the Treatment of Advanced Primary Hepatocellular Carcinoma

目的探讨125I粒子植入联合经导管肝动脉化疗栓塞(TACE)、索拉菲尼治疗中晚期原发性肝癌的临床效果。方法回顾性分析2015年7月至2018年5月郑州市第六人民医院收治的56例中晚期原发性肝癌患者的临床资料。根据治疗方式将56例患者分为2组,对照组28例患者行TACE联合索拉菲尼治疗,观察组28例患者行TACE联合索拉菲尼、125I粒子植入术。比较观察2组患者的近期疗效、不良反应、并发症、疾病无进展时间及1 a生存率。结果观察组和对照组患者有效率、疾病控制度比较差异有统计学意义(P<0.05)。观察组和对照组患者不良反应发生率比较差异均无统计学意义(P均>0.05)。观察组和对照组均未见严重并发症。观察组、对照组的中位疾病无进展时间分别为7.9个月、5.9个月,比较差异有统计学意义(P<0.05)。观察组、对照组患者1 a生存率分别为82.1%、75.0%,比较差异无统计学意义(P>0.05)。结论应用125I放射性粒子植入联合TACE、索拉菲尼的模式综合治疗中晚期原发性肝癌,近期疗效较好,安全性较高,值得临床进一步研究。

Objective To study the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE)with 125I seed and sorafenib in the treatment of advanced hepatocellular carcinoma.Methods A total of 56 patients with advanced hepatocellular carcinoma who received TACE and sorafenib combined with(the observation group,n=28)or without(the control group,n=28)implantation of 125I seed in the Sixth People’s Hospital of Zhengzhou during July 2015 and May 2018 were analyzed retrospectively.The short-time efficacy,side effects,complications,progress free survival and 1-year survival rate were compared between the two groups.Results There were statistically significant differences in the response rate and disease control rate between the observation group and the control group(P<0.05).There was no statistically significant difference in the side effects between the two groups(P>0.05).No serious complications were observed in the two groups.The median progression-free time in the observation group and the control group were 7.9 and 5.9 months,there was statistically significant difference(P<0.05).The one-year survival rates of the observation group and the control group were 82.1%and 75.0%,there was no statistically significant difference(P>0.05).Conclusion The model of TACE combined with 125I seed and sorafenib has better short-term efficacy and higher safety in the treatment of advanced hepatocellular carcinoma,which is worthy of further clinical study.