经皮微波凝固治疗不能切除肝癌及其疗效分析(附108例报告)

Efficacy of percutaneous microwave coagulation therapy for unresectable primary liver cancer: a report of 108 cases

目的 探讨经皮微波凝固治疗不能切除肝癌的方法并观察其疗效。方法 1999年 10月至 2 0 0 1年 4月运用UMC 1型超声引导微波凝固治疗仪治疗 10 8例不能切除肝癌 ,肿瘤直径 3～18cm ,其中≤ 5cm者 7例 ,1个肿瘤者 5 6例 ,2个以上肿瘤者 5 2例 ,伴门静脉主支癌栓 2 3例。在B超引导下 ,穿刺至肿瘤部位 ,每次输出功率 6 0W ,作用时间 30 0s,每 10 0s间歇 2 0s。肿瘤直径 <3cm者经行 1～ 2次微波治疗 ,≥ 3cm以上者行多点多次 (>2次 )治疗。结果 6 8例AFP阳性病人中 32例 (4 2 % )降至正常 ,14例 (2 0 6 % )AFP有不同程度下降 ;治疗后 3个月肿瘤直径平均缩小3 0cm ;术后 6个月、1年、2年生存率分别为 80 7%、6 2 9%及 35 1% ,10 8例中 18例因肿瘤缩小获二期切除。结论 不能切除的中晚期肝癌可用经皮微波凝固治疗 ,其安全、方便、易行 ,疗效佳。

Objective To evaluate the efficacy and approach of percutaneous microwave coagulation therapy for patients with unresectable hepatocellular carcinoma (HCC). Methods From October 1999 to April 2001, microwave coagulation therapy was employed to treat 108 patients with unresectable HCC with a diameter ranging from 3 to 18 cm (less than 5 cm in 7 cases). Of the patients, 56 had one tumor and 52 two or over two tumors. Meanwhile, HCC with portal vein tumor thrombi was found in 23 patients. Acupuncture into tumors was guided by ultrasound. Radiation output at 60 watts lasted for 300 seconds with 20 seconds of intermittence per 100 seconds. The tumors less than 3 cm in diameter received one or two treatments while others received more than two times in different sites. Results Of the 68 patients with elevated AFP, AFP returned to normal in 32 (42%) and dropped to some extent in 14 (20.6%). Three months later, the tumors shrank for an average of 3 cm in diameter. The 6-month, 1-year and 2-year survival rates were 80.7%, 62.9% and 35.1%, respectively. Eighteen of the 108 patients underwent two-stage resection. Conclusions Percutaneous microwave coagulation therapy is a safe, convenient and effective treatment for unresectable HCC.