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。