^(125)I粒子植入联合肝动脉灌注化疗栓塞治疗原发性肝癌的疗效分析

Efficacy analysis of ^(125)I seeds implantation combined with transcatheter arterial chemoembolization therapy for primary liver cancer

目的探讨125I粒子联合经导管动脉化疗栓塞(TACE)治疗原发性肝癌的临床疗效。方法回顾性分析2018年1月至2020年12月北部战区总医院40例原发性肝癌患者的资料(男26例、女14例, 年龄41~82岁), 其中治疗组21例, 行125I粒子联合TACE治疗;对照组19例, 行TACE治疗。比较2组患者甲胎蛋白(AFP)水平, 分析2组患者的有效率、疾病控制率(DCR), 观察患者的总生存期(OS)、无进展生存期(PFS)。采用Mann-WhitneyU检验、χ^(2)检验、Kaplan-Meier法和log-rank检验分析数据。结果 125I粒子植入后2个月, 治疗组与对照组的有效率分别为76.19%(16/21)和8/19, 差异有统计学意义(χ^(2)=4.83, P=0.028);DCR分别为90.48%(19/21)和11/19(χ^(2)=4.21, P=0.040)。2组患者AFP均明显下降, 治疗组下降率大于对照组[0.87(0.84, 0.90)与0.66(0.65, 0.67);z=5.42, P<0.001]。2组患者均未发生严重不良反应。治疗组与对照组中位OS分别为18.2和10.6个月(χ^(2)=10.98, P=0.037);2组中位PFS分别为8.4和6.1个月(χ^(2)=7.54, P=0.041)。结论 125I粒子联合TACE治疗原发性肝癌可发挥协同增效作用。

Objective To explore the clinical efficacy of ^(125)I seeds implantation combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer.Methods A retrospective analysis of data from 40 patients with primary liver cancer at the Northern Theater General Hospital from January 2018 to December 2020(26 males,14 females,age 41 to 82 years)was performed.Among them,21 patients were in treatment group and underwent ^(125)I seeds implantation combined with TACE treatment,while 19 patients were in control group and received TACE treatment.Alpha-fetoprotein(AFP)levels between the two groups were compared,effective rate and disease control rate(DCR)of the two groups were analyzed,and overall survival(OS)and progression-free survival(PFS)were observed.Data were analyzed by using Mann-Whitney U test,χ^(2) test,Kaplan-Meier method and log-rank test.Results Two months after ^(125)I seeds implantation,the effective rates of treatment group and control group were 76.19%(16/21)and 8/19,respectively(χ^(2)=4.83,P=0.028);the DCRs were 90.48%(19/21)and 11/19,respectively(χ^(2)=4.21,P=0.040).AFP levels in both groups decreased significantly,with treatment group showing a greater decrease rate(0.87(0.84,0.90)and 0.66(0.65,0.67);z=5.42,P<0.001).No serious adverse reaction was observed in either group.The median OS of treatment group and control group were 18.2 and 10.6 months,respectively(χ^(2)=10.98,P=0.037);the median PFS of the two groups were 8.4 and 6.1 months,respectively(χ^(2)=7.54,P=0.041).Conclusion ^(125)I seeds implantation combined with TACE treatment can exert a synergistic and enhancing effect in the treatment of primary liver cancer.