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经动脉油性化疗栓塞联合间质激光热疗治疗肝细胞癌

[Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma].

作者信息

Zhou Ze-jian, Xu Rong-de, Li Wei-ke, Zhuang Wen-xing, Lu Li-gong, Shao Pei-jian, Chen Xiao-ming, Luo Peng-fei

机构信息

Department of Oncology and Interventional Therapy, Cancer Center, Guangdong Provincial People's Hospital, Guangzhou 510080, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2007 Dec;27(12):1866-8.

PMID:18159005
Abstract

OBJECTIVE

To evaluate the therapeutic effects and adverse effects of transarterial oily chemoembolization combined with interstitial laser thermotherapy (TOCE+ILT) in the treatment of hepatocellular carcinoma.

METHODS

Totally 120 patients with hepatocellular carcinoma were randomized into two groups and received interventions with TOCE+ILT or TOCE combined with percutaneous ethanol injection (TOCE+PEI). The treatment was repeated when necessary until the tumor was completely ablated, after which the therapeutic effects were evaluated and the patients were the followed up for observing long-term clinical outcome.

RESULTS

Of the 120 patients enrolled in this observation, 105 were followed up for two years (54 in TOCE+ILT group and 51 in TOCE+PEI group). The complete tumor necrosis rate of TOCE+ILT group was significantly higher than that of the TOCE+PEI group (84.8% vs 73.9%,Chi(2)=4.405, P=0.036), and TOCE+ILT was associated with a significantly higher negative conversion rate of AFP positivity (77.8% vs 56.1%, Chi(2)=4.592, P=0.032). The 1-year survival rate were similar between two groups, but the 2-year survival rate was significantly higher in patients with TOCE+ILT (79.6% vs 60.8%, Chi(2)=4.477, P=0.034). The hepatic function was comparable between the two groups before treatment, and 1 week after treatment, the ALT level in patients undergoing TOCE+ILT was significantly lower than that in patients with TOCE+PEI (95.90-/+56.06 U/L vs 116.31-/+45.27 U/L, t=2.04, P=0.043). Post-embolization syndrome was observed in the patients in two groups, but no severe adverse events were found.

CONCLUSION

TOCE+ILT has good therapeutic effects and mild side effects in the treatment of hepatocellular carcinoma.

摘要

目的

评估经动脉油性化疗栓塞联合间质激光热疗(TOCE+ILT)治疗肝细胞癌的疗效及不良反应。

方法

将120例肝细胞癌患者随机分为两组,分别接受TOCE+ILT或TOCE联合经皮乙醇注射(TOCE+PEI)治疗。必要时重复治疗直至肿瘤完全消融,之后评估疗效并对患者进行随访以观察长期临床结局。

结果

本观察纳入的120例患者中,105例进行了两年随访(TOCE+ILT组54例,TOCE+PEI组51例)。TOCE+ILT组的肿瘤完全坏死率显著高于TOCE+PEI组(84.8%对73.9%,χ²=4.405,P=0.036),且TOCE+ILT与AFP阳性转阴率显著更高相关(77.8%对56.1%,χ²=4.592,P=0.032)。两组1年生存率相似,但TOCE+ILT患者的2年生存率显著更高(79.6%对60.8%,χ²=4.477,P=0.034)。两组治疗前肝功能相当,治疗1周后,TOCE+ILT患者的ALT水平显著低于TOCE+PEI患者(95.90±56.06 U/L对116.31±45.27 U/L,t=2.04,P=0.043)。两组患者均观察到栓塞后综合征,但未发现严重不良事件。

结论

TOCE+ILT治疗肝细胞癌具有良好的疗效且副作用轻微。

相似文献

1
[Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma].经动脉油性化疗栓塞联合间质激光热疗治疗肝细胞癌
Nan Fang Yi Ke Da Xue Xue Bao. 2007 Dec;27(12):1866-8.
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[Transarterial oil chemoembolization for hepatocellular carcinoma, in 100 cases].
Harefuah. 2000 Jan 16;138(2):89-93, 174.
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[Long-term result of combination of transcatheter arterial chemoembolization and percutaneous ethanol injection for treatment of hepatocellular carcinoma].经动脉化疗栓塞术与经皮乙醇注射联合治疗肝细胞癌的长期结果
Ai Zheng. 2004 Jul;23(7):829-32.
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J Med Assoc Thai. 2002 Dec;85(12):1280-7.
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Ruptured hepatocellular carcinoma as a complication of transarterial oily chemoembolization.
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[Hepatocellular carcinoma: percutaneous ethanol injection/transarterial chemoembolization/radiofrequency thermoablation].肝细胞癌:经皮乙醇注射/经动脉化疗栓塞/射频热消融
Praxis (Bern 1994). 2000 Jun 15;89(24):1056-60.
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Transcatheter arterial chemoembolization therapy combined with percutaneous ethanol injection for unresectable large hepatocellular carcinoma: an evaluation of the local therapeutic effect and survival rate.经导管动脉化疗栓塞术联合经皮乙醇注射治疗不可切除的大肝细胞癌:局部治疗效果和生存率评估
Hepatogastroenterology. 2001 Sep-Oct;48(41):1409-15.
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Hepatocellular carcinoma : treated with hepatic arterial embolization, an analysis of prognostic features in 150 cases.肝细胞癌:经肝动脉栓塞治疗,150例预后特征分析
J Med Assoc Thai. 2000 Sep;83(9):983-91.
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[Combined percutaneous ethanol injection through liver puncture and transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma].经肝穿刺联合经导管肝动脉化疗栓塞术治疗肝细胞癌的经皮乙醇注射治疗
Zhonghua Zhong Liu Za Zhi. 2001 Nov;23(6):490-2.
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Hepatocellular carcinoma in the elderly: results of surgical and nonsurgical management.老年肝细胞癌:手术及非手术治疗结果
Am J Gastroenterol. 1999 Sep;94(9):2460-6. doi: 10.1111/j.1572-0241.1999.01376.x.

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