| 朱楠,鲁东,吕维富,成德雷,周春泽,张行明,张正峰,肖景坤.TACE联合放射性125I粒子植入治疗不宜消融肝癌的安全性及有效性分析[J].中国介入影像与治疗学,2018,15(10):586-591 |
| TACE联合放射性125I粒子植入治疗不宜消融肝癌的安全性及有效性分析 |
| Safety and efficacy of TACE combined with radioactive 125I seed implantation in treatment of hepatocellularcarcinoma of not good indication for ablation |
| 投稿时间：2018-01-01 修订日期：2018-08-01 |
| DOI：10.13929/j.1672-8475.201801002 |
| 中文关键词: 肝肿瘤 栓塞,治疗性 碘放射性同位素 |
| 英文关键词:Liver neoplasms Embolization,therapeutic Iodine radioisotopes |
| 基金项目:国家卫计委医学科研专项项目（w2015xr13）、安徽省自然科学基金（1408085MH162）、安徽省科技攻关项目（1704a0802152）、天晴肝病研究基金项目（TQGB20180247）。 |
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| 中文摘要: |
| 目的 评价TACE联合125I粒子植入治疗不宜消融肝癌的疗效。方法 将82例不宜消融的肝癌患者分为2组：联合组40例，予TACE联合125I粒子植入治疗；对照组42例，予单纯TACE治疗。比较2组治疗后肝功能、血常规、血清甲胎蛋白（AFP）、并发症、客观有效率及远期生存率。结果 联合组125I粒子植入术前、术后剂量学差异均无统计学意义（P均>0.05）。联合组术后3、6个月客观有效率[85.00%（34/40）、67.50%（27/40）]明显高于对照组[61.90%（26/42）、45.24%（19/42）；P均<0.05]。联合组患者中位生存时间为25.7个月，对照组为10.7个月；联合组1、2、3年累积生存率分别为77.50%、54.30%、23.30%，对照组为45.20%、32.60%、13.60%。联合组术后3个月及6个月血清AFP水平明显低于对照组（P均<0.05）。联合组治疗后1个月肝功能及血常规与术前差异均无统计学意义（P均>0.05）。结论 TACE联合125I治疗不宜消融肝癌安全、有效。 |
| 英文摘要: |
| Objective To investigate the efficacy and safety of TACE combined with 125I seed implantation in the treatment of liver cancer of not good indication for ablation.Methods Eighty-two patients with liver cancer of not good indication for ablation were retrospectively analyzed. The patients were divided into two groups, 40 in combined group received TACE combined with CT-guided 125I seed implantation and 42 in control group underwent TACE alone. Hepatic function, blood routine, serum alpha-fetoprotein (AFP) level, complications, local efficiency and the long-term survival rates after treatment were compared between groups.Results There was no significant difference of dosimetry pre- and post- 125I implantation (all P>0.05). The objective effective rate of combined group (85.00%[34/40], 67.50%[27/40]) 3, 6 months after operation was significantly higher than those of control group (61.90%[26/42], 45.24%[19/42]; both P<0.05). The median survival time was 25.7 months of combined group and 10.7 months of control group. The 1-year, 2-year and 3-year cumulative survival rates of combined group were 77.50%, 54.30% and 23.30%, respectively, while of control group were 45.20%, 32.60% and 13.60%, respectively. AFP in combined group 3 months and 6 months after operation were significantly higher than in control group (both P<0.05). There was no significant difference of hepatic function preoperative and 1 month postoperative, nor of blood routine in combined group (both P>0.05).Conclusion TACE combined 125I seed implantation is safe and effective in the treatment of liver cancer of not good indication for ablation. |
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