摘要
[目的]探讨多学科治疗模式（multiple disciplinary team，MDT）在中晚期肝癌患者中的临床疗效。[方法]选择186例中晚期肝癌患者，先行介入治疗，将肿瘤缩小至3～5cm后，再行伽马刀治疗。同时配合肿瘤自体细胞免疫疗法及中医疗法进一步清除体内的肿瘤细胞。评价MDT的临床应用效果及毒副反应。[结果]186例中晚期肝癌患者均进行MDT治疗，以介入治疗和伽马刀治疗为主，配合肿瘤自体细胞免疫疗法及放疗和中医药治疗。首先介入治疗使肿瘤直径缩小至5cm以内，共有139例，经3次肝动脉栓塞化疗（TACE）肿块直径仍大于5cm患者共47例。178例患者接受伽马刀治疗，另8例弥漫型未行伽马刀治疗。经MDT治疗后，186例近期临床总有效率为90．9％；生存1年者146例（78．5％），生存2年者109例（58．6％），生存3年者93例（50．0％），生存4年者64例（34．4％），生存5年者37例（19．9％）。治疗过程中常见的毒副反应为胃肠道反应、血细胞减少和血小板减少，其中，0级反应占67．2％（125例），Ⅰ～Ⅱ级反应占32．8％（61例）。[结论]MDT治疗中晚期肝癌临床疗效确切，且毒副反应较小，可在临床推广应用。
[Objective] To investigate the clinical efficacy of multiple disciplinary team （MDT） in patients with advanced liver cancer. [Methods]One hundred and eighty-six patients with advanced hepatocellular hepatic carcinoma received interventional therapy to shrink the tumor to 3 - 5cm, followed by gamma treatment. At the same time, the autologous celt immunotherapy and traditional Chinese medicine therapy were performed to further clear tumor cells. Clinical application effect and toxicity of MDT were evaluated.[Resuhs] One hundred and eighty-six patients with advanced hepatocellular carcinoma underwent MDT therapy followed BY immunotherapy and radiotherapy of tumor autologous cells and treatment of Chinese medicine. First, interventional therapy was conducted ,the tumor diameter was reduced to 5 cm in a total of 139 cases; 47 cases were still larger than 5 cm in diameter after 3 times of Transcatheter arterial chemoembolization （TACE）. 178 patients were treated with gamma knife treatment, The other 8 cases of diffuse type had no gamma knife treatment. After MDT treatment, the clinical total effective rate was 90.9% in186 cases of; 146 cases survived 1 year （78.5%）, 109 cases of 2 years survival （58.6%）, 93 cases of 3 years survival （50%）, 64 cases of 4 years survival （34.4%）, 37 cases of 5 years survival （19.9%）. During the treatment, the side effects were gastrointestinal reaction, blood cell reduction and thrombocytopenia. Among them, Grade 0 reactions accounted for 67.2% （125 cases）, and Ⅰ-Ⅱ level reactions accounted for 32.8% （61 cases）.[Conclusion]The clinical efficacy of MDT treatment in advanced hepatocellular carcinoma is exact with less toxicity. It is worthy of clinical application.
出处
《医学临床研究》
CAS
2016年第9期1757-1759,1763,共4页
Journal of Clinical Research
