经皮导管动脉化疗栓塞联合碘^125放射粒子植入治疗中晚期原发性肝癌的疗效

Comparative Study of TACE Treatment and TACE Combined with Iodine 125 Radiation Particle Implantation in the Treatment of Advanced Hepatocellular Carcinoma

【目的】探讨经皮导管动脉化疗栓塞(TACE)联合碘^125放射粒子植入治疗中晚期原发性肝癌患者的临床疗效。【方法】本院收治的100例中晚期原发性肝癌患者根据治疗方法分为联合组55例(TACE联合碘^125放射粒子植入治疗)和TACE组(单纯使用TACE治疗)45例;比较两组患者的疗效、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甲胎蛋白(AFP)、总胆红素(TBIL)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、基质金属蛋白酶9(MMP9)及毒副反应。【结果】联合组患者的完全缓解(CR)+部分缓解(PR)率为65.45%,高于TACE组的46.67%(P<0.05);治疗前两组患者的血清各相关指标水平比较差异无显著性(P>0.05);治疗后,联合组患者的A FP、NGAL、MMP9水平均低于TACE组(P<0.05);联合组的恶心、腹痛发生率显著高于TACE组(P<0.05);联合组的呕吐、腹泻、肝功能损害发生率与TACE组比较差异无显著性(P>0.05);联合组的中位生存时间(14.0个月)长于对照组(9.0个月)(P<0.05)。【结论】TACE联合破^125放射粒子植入治疗中晚期不能手术的肝癌患者较单纯的TACE手术具有更好的疗效,但是可能会增加毒副反应发生率。

【Objective】To investigate the clinical effects of TACE combined with iodine 125 radiation particle implantation in the treatment of patients with advanced hepatocellular carcinoma.【Methods】A retrospective analysis of 100 patients with advanced hepatocellular carcinoma from our hospital was studied.According to the treatment,there were 55 patients in the combined group(TACE combined with iodine 125 radiation particle implantation)and 45 cases in TACE group(only treated with TACE).Chemotherapy effects,serum ALT,AST,AFP,TBIL,NGAL,MMP9 and toxic side effects were compared between the two groups.【Results】The CR and PR rate of the combined group was 65.45%,which was higher than that of the TACE group 46.67%(P<0.05).Before treatment,the serum levels of ALT,AST,AFP,TBIL,NGAL and MMP9 in two groups were not statistically significant(P>0.05).After treatment,the A FP,NGAL,and MMP9 levels in the combined group were lower than those in the TACE group(P<0.05).The incidence of nausea and abdominal pain in the combined group was significantly higher than that in the TACE group(P<C0.05).The incidence of vomiting,diarrhea,and liver damage in the combined group was not significantly different from that in the TACE group(P>0.05).The median survival time was 14.0 months in the combined group and 9.0 months in the control group.The difference between the two groups was statistically significant(P<0.05).【Conclusion】TACE combined with iodine 125 radioactive particle implantation in patients with middle and late stage liver cancer is better than simple TACE surgery,but it may aggravate the incidence of side effects in patients.