CT引导下^(125)I放射性粒子植入和微波消融治疗肝癌患者的效果比较

Comparison of effects of CT-guided ^(125)I radioactive particle implantation and microwave ablation in treatment of liver cancer patient

目的:比较CT引导下^(125)I放射性粒子植入和微波消融治疗肝癌患者的效果比较。方法:回顾性分析2018年3月至2019年3月该院收治的104例早中期肝癌患者的临床资料,按照治疗方式不同分为对照组40例和观察组64例。对照组采用CT引导下微波消融治疗,观察组采用CT引导下^(125)I放射性粒子植入治疗。比较两组治疗后6个月近期疗效,治疗前及治疗后1、3、6个月肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)、甲胎蛋白(AFP)及癌胚抗原(CEA)]水平,以及并发症发生率,治疗后2年的复发率和生存率。结果:观察组近期疗效及客观缓解率比较,差异均无统计学意义(P>0.05);治疗后1个月,观察组CA125、AFP、CEA、CA199水平高于对照组,治疗后6个月观察组CA125、AFP、CEA、CA199水平低于对照组,差异均有统计学意义(P<0.05);两组并发症发生率、2年生存率比较,差异均无统计学意义(P>0.05);随访2年后,观察组复发率为7.81%(5/64),低于对照组的22.50%(9/40),差异有统计学意义(P<0.05)。结论:CT引导下^(125)I放射性粒子植入与微波消融术治疗早中期肝癌近期疗效、安全性接近,^(125)I放射性粒子植入术可明显降低术后6个月时的血清肿瘤标志物水平及术后2年复发率,两种方法术后2年生存率接近。

Objective: To compare effects of CT-guided^(125)I radioactive particle implantation and microwave ablation in treatment of liver cancer patient. Methods: The clinical data of 104 patients with early and intermediate stage liver cancer admitted to this hospital from March 2018 to March 2019 were retrospectively analyzed. According to different treatment methods, they were divided into control group(40 cases) and observation group(64 cases). The control group was treated with CT-guided microwave ablation, while the observation group was treated with CT-guided^(125)I radioactive particle implantation. The short-term efficacy 6 months after the treatment, the levels of tumor markers [carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199), alpha-fetoprotein(AFP) and carcinoembryonic antigen(CEA)] before and 1, 3 and 6 months after the treatment,the incidence of complications, the recurrence rate and the survival rate 2 years after the treatment were compared between the two groups. Results:There were no significant differences in the short-term efficacy and the objective remission rate between the two groups(P>0.05). 1 month after treatment, the levels of CA125, AFP, CEA and CA199 in the observation group were higher than those in the control group;the levels of CA125,AFP, CEA and CA199 in the observation group were lower than those in the control group 6 months after the treatment;and the differences were statistically significant(P<0.05). There were no significant differences in the incidence of complications and the 2-year survival rate between the two groups(P>0.05). Further, after 2 years of follow-up, the recurrence rate of the observation group was 7.81%(5/64), which was lower than 22.50%(9/40) of the control group, and the difference was statistically significant(P<0.05). Conclusions: The short-term efficacy and the safety of CT-guided^(125)I radioactive particle implantation n and microwave ablation in the treatment of early and intermediate stage liver cancer are similar. The former can significantly reduce the levels of serum tumor markers 6 months after the treatment and the recurrence rate 2 years after the treatment. However, the 2-year survival rates of the two methods are similar.