TACE联合125I粒子植入内照射治疗特殊部位原发性肝癌的临床疗效观察

Clinical effect of TACE combined with 125I seed implantation and internal irradiation in the treatment of primary liver cancer in special areas

目的探究TACE联合125I粒子植入内照射治疗特殊部位原发性肝癌的近期疗效及安全性。方法选取本院2017年1月至2019年1月收治的特殊部位原发性肝癌患者60例,采用随机数字表法分为对照组和观察组,各30例。对照组采用单纯经肝动脉化疗栓塞术(TACE)治疗,观察组采用TACE联合125I粒子植入内照射治疗,比较两组患者近期疗效,临床不良反应及12个月生存情况。结果观察组患者有效率(70.00%)高于对照组(43.33%),病情控制率(83.33%)高于对照组(56.67%),差异均有统计学意义(P<0.05);观察组患者6个月、9个月及12个月生存率(86.67%、80.00%、76.67%)均高于对照组(63.33%、50.00%、46.67%),差异有统计学意义(P<0.05);两组患者呕吐、腹胀腹痛、气胸、骨髓抑制、转氨酶异常及粒子迁移等临床不良反应发生率比较差异无统计学意义。结论TACE联合125I粒子植入内照射治疗可有效提高特殊部位肝癌患者有效率及病情控制率,延长生存时间,疗效满意,安全性高,值得临床应用和推广。

Objective To evaluate the short-term efficacy and safety of TACE combined with 125I seed implantation and internal irradiation in the treatment of primary liver cancer in special sites.Methods From January 2017 to January 2019,60 patients with primary liver cancer at special sites were selected.The patients were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with transcatheter arterial chemoembolization(TACE)alone,and the observation group was treated with TACE combined with 125I seed implantation and internal irradiation.The short-term efficacy,clinical adverse reactions and 12-month survival were compared between the two groups.Results The effective rate(70.00%)of the observation group was higher than that of the control group(43.33%),the disease control rate(83.33%)was higher than that of the control group(56.67%),and the difference was statistically significant(P<0.05).The 6-month,9-month and 12-month survival rates of the observation group(86.67%,80.00%,76.67%)were higher than those of the control group(63.33%,50.00%,46.67%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of clinical adverse reactions between the two groups of patients,such as vomiting,abdominal distension,pneumothorax,bone marrow suppression,abnormal transaminase,and particle migration.Conclusion TACE combined with 125I seed implantation can effectively improve the effective rate and disease control rate of patients with liver cancer in special site,prolong the survival time,have satisfactory effect and high safety,which is worthy of application and promotion.