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经导管动脉化疗栓塞联合经皮微波凝固治疗晚期肝细胞癌的临床疗效

Clinical Efficacy of Transcatheter Arterial Chemoembolization Combined With Percutaneous Microwave Coagulation Therapy for Advanced Hepatocellular Carcinoma.

作者信息

Ren Hu Hu, Wu Zhi Qun, Chen Jian, Li Chen

机构信息

Department of Intervention, Fourth Military Medical University Affiliated Tangdu Hospital, Xi'an, Shaanxi 7100322, China.

Interventional Diagnosis and Treatment Center, Red Cross Hospital of Xi'an, Shaanxi 710061, China.

出版信息

Gastroenterology Res. 2024 Aug;17(4):175-182. doi: 10.14740/gr1713. Epub 2024 Jul 18.

Abstract

BACKGROUND

The aim of the study was to explore the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation therapy (PMCT) for advanced hepatocellular carcinoma (HCC).

METHODS

Eighty-three advanced HCC patients were divided into the experimental group (TACE + PMCT, 57 cases) and the control group (TACE alone, 26 cases). They received TACE treatment first, and computed tomography (CT) or hepatic artery angiography was performed 3 - 4 weeks after each treatment. Based on the comprehensive evaluation of iodine oil deficiency, fistula recanalization, residual lesions, and lesion progression, TACE or PMCT treatment was selectively performed, and three consecutive treatments were considered as one treatment cycle.

RESULTS

The experimental group had a response rate (RR) of 49.1%, and the control group had a RR of 38.4%. The reduction rate of alpha-fetoprotein (AFP) in the experimental group was significantly higher than the control group (P < 0.05). The cumulative survival rates in the experimental at 1-, 1.5-, and 2-year post-treatment were higher than the control group. The cumulative recurrence and metastasis rates in the experimental at 1.5-, and 2-year post-treatment were significantly lower than those in the control group (P < 0.05). In addition, there were no significant differences in treatment-related complications in the two groups.

CONCLUSIONS

The combined treatment of TACE and PMCT for advanced HCC is a safe, feasible, and effective treatment method, prolonging the survival time, and reducing the recurrence and metastasis rate, without increased toxic and side effects.

摘要

背景

本研究旨在探讨经动脉化疗栓塞术(TACE)联合经皮微波凝固治疗(PMCT)用于晚期肝细胞癌(HCC)的临床疗效。

方法

83例晚期HCC患者被分为实验组(TACE + PMCT,57例)和对照组(单纯TACE,26例)。他们首先接受TACE治疗,每次治疗后3 - 4周进行计算机断层扫描(CT)或肝动脉血管造影。基于对碘油充盈缺损、瘘管再通、残余病灶及病灶进展的综合评估,选择性地进行TACE或PMCT治疗,连续三次治疗视为一个治疗周期。

结果

实验组的有效率(RR)为49.1%,对照组的RR为38.4%。实验组甲胎蛋白(AFP)的降低率显著高于对照组(P < 0.05)。实验组治疗后1年、1.5年和2年的累积生存率高于对照组。实验组治疗后1.5年和2年的累积复发和转移率显著低于对照组(P < 0.05)。此外,两组治疗相关并发症无显著差异。

结论

TACE与PMCT联合治疗晚期HCC是一种安全、可行且有效的治疗方法,可延长生存时间,降低复发和转移率,且不增加毒副作用。

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