摘要
目的观察TACE、PVE、HIFU序贯治疗原发性肝癌（PLC）的临床疗效。方法将不能手术的PLC 76例分为2组,观察组42例先行TACE治疗,2周后行PVE治疗,PVE治疗后10 d左右行HIFU治疗,每2-3个月进行序贯治疗1次,共2-5次;对照组34例采用TACE＋PVE治疗。评价两组的疗效和治疗相关毒副反应。结果观察组42例共行TACE 130次,平均3.1次/例;PVE 118次,平均2.8次/例;HIFU147次,平均3.5次/例。对照组34例行TACE 123次,平均3.6次/例;PVE 102次,平均3.0次/例。观察组和对照组总有效率分别为73.8%（31/42）、44.1%（15/34）,两组比较差异有统计学意义（P〈0.01）;合并门静脉癌栓经治疗后癌栓消失或缩小1/2以上者,观察组70.6%（12/17）,对照组28.6%（4/14）,两组比较差异有统计学意义（P〈0.05）;AFP升高而治疗后转阴或滴度下降1/2以上者,观察组67.6%（23/34）,对照组37.0%（10/27）,两组比较差异有统计学意义（P〈0.05）;观察组6、12、24、36、60个月生存率分别为88.1%、73.8%、40.5%、26.2%、14.3%,对照组分别为52.9%、41.2%、20.6%、11.8%、2.9%（P〈0.05）。结论TACE、PVE、HIFU序贯治疗PLC疗效较好,可以提高肿瘤局部控制率,延长生存期,且治疗相关毒副反应可耐受。
Objective To observe the clinical effects of sequential therapy of TACE,PVE,HIFU in the treatment of primary liver carcinoma（PLC）.Methods 76 inoperative PLC patients were divided randomly into two groups.The observation group was treated with TAE first,then PVE two weeks later,HIFU was given ten days after PVE.The sequential therapy cycle was 2-3 months,and 2-5 times were performed totally.The control group was treated with TAE and PVE.The clinical effects and toxicities of the two groups were recorded respectively.Results In the observation group,42 patients were given TACE 130 times,PVE 118 times,and HIFU 147 times;average 3.1,2.8 and 3.5 times per case respectively.In the control group,34 patients were given TACE 123 times,PVE 102 times,average 3.6 and 3.0 times per case respectively.The total response rate was 73.8%（31/42） in the observation group and 44.1%（15/34） in the control group（P〈0.01）.In the patients with portal vein tumor thrombus,the percentage of patients whose thrombus reduced over 1/2 after treatment was 70.6%（12/17） in the observation groups,and 28.6%（4/14） in the control group（P〈0.05）.The percentage of patients whose AFP decreased over 1/2 was 67.6%（23/34） in the observation group,and 37.0%（10/27） in the control group（P〈0.05）.The 6,12,24,36 and 60 months survival rate was 88.1%,73.8%,40.5%,26.2%,14.3% in the observation group respectively,and 52.9%,41.2%,20.6%,11.8%,2.9% in the control group respectively（P〈0.05）.Conclusion The sequential therapy of TACE,PVE,HIFU for PLC is effective,and can increase local control rate of tumor,prolong survival duration;the toxicities is tolerable.
出处
《肿瘤基础与临床》
2010年第1期32-34,共3页
journal of basic and clinical oncology
关键词
原发性肝癌
肝动脉化疗栓塞
门静脉化疗栓塞
高强度聚焦超声
primary liver carcinoma
transcatheter arterial chemoembolization
portal vein embolization
high intensity focused ultra sound
