肝动脉化疗栓塞联合伽玛刀序贯治疗中晚期肝细胞癌的疗效分析

摘要

Objective To evaluate the therapeutic effect of transcatheter arterial chemoembolizalion (TACE) combined with gamma knife in patients with middle and advanced hepatocellular carcinoma.Methods Total 62 cases of middle and advanced hepatocellular carcinoma were composed of 30 cases who received only TACE two to three times (Control group) and 32 cases who received serial TACE and gamma knife radiotherapy (Combined treatment group). All post-treated patients received color Doppler ultrasound and CT scan after one course of treatment. AFP level, Tumor Shrinkage rate, 1 or 2 years survival rate, and adverse reaction are evaluated as the compared index. Results The negative rate of AFP, tumor Shrinkage rate, 1 or 2 years survival rate in combined treatment group are significantly higher than those in control group (82.1％ versus 32.1％, P＜0.05), (86.7％ versus 62.3％, P＜0. 05),(86.7 ％ versus 62.5％, P＜0.05), (66.7％ versus 40.6％, P＜0.05), respectively. There is no statis tical significance in adverse reaction between two groups. Conclusion Combined treatments of TACE;and gamma knife for middle-advanced hepatocellular carcinoma are safe and effective, which may improve treatment efficacy and prolong survival time.%目的 探讨肝动脉化疗栓塞(TACE)联合伽玛刀序贯治疗中晚期肝细胞癌(HCC)的疗效.方法 62例中晚期HCC患者分为联合组(30例)和对照组(32例),联合组行序贯TACE→伽玛刀→TACE治疗,对照组仅行TACE治疗2～3次.治疗1个疗程后,全部病例复查彩超、CT,比较2组患者甲胎蛋白(AFP)水平变化、肿瘤缩小程度及1、2年生存率和不良反应.结果 联合组AFP转阴率、肿瘤缩小率及1、2年生存率分别为82.1%、86.7%、86.7%、66.7%,明显高于对照组的32.1%、62.3%、62.5%、40.6%(P均<0.05);而2组不良反应方面比较差别无统计学意义(P>0.05).结论 TACE与伽玛刀序贯治疗中晚期HCC安全有效,可明显改善其治疗效果,并延长患者的生存期.