肝动脉导管化疗栓塞联合125I粒子植入治疗原发性肝癌的效果分析

摘要

目的 分析肝动脉导管化疗栓塞(TACE)联合125I放射粒子植入治疗原发性肝癌的效果.方法 选取湖北医药学院附属人民医院2010年3月至2013年2月收治的94例PHC患者作为研究对象,根据入院时间先后将所有患者分为观察组和对照组,各47例.对照组给予TACE治疗,观察组给予TACE联合125I放射粒子植入治疗.比较2组患者的血清甲胎蛋白水平变化、近期疗效、不良反应发生率和生存率.结果 治疗前观察组甲胎蛋白阳性患者22例、对照组21例,治疗后1个月观察组甲胎蛋白转阴率和总降低率均明显高于对照组[59.1％(13/22)比28.6％ (6/21),x2=5.82,P=0.01;95.5％ (21/22)比81.0％ (17/21),x2=3.86,P=0.04].治疗后2个月,观察组的总有效率明显高于对照组[85.1％ (40/47)比68.1％ (32/47),x2=5.59,P=0.01];2组不良反应发生率比较差异无统计学意义(P＞0.05).观察组的1年、2年、3年生存率均明显高于对照组[93.6％ (44/47)比80.9％ (38/47),x2 =4.71,P=0.03;78.7％(37/47)比53.2％ (25/47),x2=6.82,P＜0.01;55.3％ (26/47)比34.0％(16/47),x2 =6.15,P=0.01].结论 TACE联合125I放射粒子植入治疗可明显提高原发性肝癌患者的近期疗效和生存率,同时降低血清甲胎蛋白水平,是一种高效的联合治疗方案.%Objective To analyze the efficacy of transcatheter arterial chemoembolization (TACE in combination with 125I seed implantation in the treatment of primary liver cancer.Methods A total of 94 cases of primary liver cancer from March 2010 to February 2013 in Renmin Hospital,Hubei University of Medicine were divided into observation group and control group,with 47 cases in each group.The control group had TACE;the observation group had TACE in combination with 125I seed implantation.Serum alpha-fetoprotein (AFP) level,short-term efficacy,adverse reaction incidence and survival rate were analyzed.Results The negative conversion rate and total reduction rate of AFP in observation group(22 patients with positive AFP) were significantly higher than those in control group(21 patients with positive AFP) 1 month after treatment[59.1％ (13/22) vs 28.6％ (6/21),x2 =5.82,P =0.01;95.5％ (21/22) vs 81.0％ (17/21),x2 =3.86,P =0.04].The total effective rate in observation group was significantly higher than that in control group 2 months after treatment [85.1％ (40/47) vs 68.1％ (32/47),x2 =5.59,P =0.01].The adverse reaction incidence had no significant difference between groups(P ＞ 0.05).The 1-,2-,3-year survival rates in observation group were significantly higher than those in control group [93.6 ％ (44/47) vs 80.9 ％ (38/47),x2 =4.71,P =0.03;78.7 ％ (37/47) vs 53.2％ (25/47),x2 =6.82,P＜0.01;55.3％(26/47) vs34.0％(16/47),x2 =6.15,P=0.01].Conclusion TACE in combination with 125I seed implantation can increase short-term efficacy,reduce AFP level and improve survival rate in patients with primary liver cancer.