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目的探讨肝动脉药物栓塞(TACE)、射频消融(RFA)联合125Ⅰ粒子植入治疗肝细胞肝癌(HCC)的临床应用价值。方法 2008年3月至2010年12月收治15例HCC患者(共25个肿瘤灶),病灶大小1～8 cm。对所有患者均先进行TACE,然后在CT引导下进行RFA及125Ⅰ粒子植入治疗。125Ⅰ粒子植入通过TPS计划,对肝内同一病灶,在RFA结束时植入粒子进行补充治疗,或对多发病例中RFA受限的病灶直接植入粒子进行治疗。放疗剂量为60～100 Gy,随访观察疗效及相关并发症。结果随访时间3～28个月(平均10.6个月),全组肿瘤完全坏死率为96%,除1例粒子游走外,未出现其他严重并发症。结论 TACE、RFA联合125Ⅰ粒子植入治疗HCC,近期疗效明显,可望成为HCC更有效的治疗新模式。
Objective To investigate the clinical value of hepatic arterial chemoembolization (TACE), radiofrequency ablation (RFA) combined with 125 Ⅰ particle implantation in the treatment of hepatocellular carcinoma (HCC). Methods From March 2008 to December 2010, 15 patients with HCC (25 tumor nests) were enrolled. The size of the lesion was 1 ~ 8 cm. All patients were TACE first, and then under the guidance of CT RFA and 125I particle implantation. 125I Particle Implantation Through the TPS program, the same intrahepatic lesion, particles implanted at the end of the RFA, are complemented with therapies, or directly implanted particles for RFA-restricted lesions in multiple cases. Radiotherapy dose was 60 ~ 100 Gy, follow-up observation of efficacy and related complications. Results The follow-up time ranged from 3 months to 28 months (average 10.6 months). The complete tumor necrosis rate was 96%. No other serious complications occurred except for the migration of one patient. Conclusion TACE and RFA combined with 125 Ⅰ particle implantation for the treatment of HCC have obvious curative effect in the short term and are expected to be a more effective new treatment modality for HCC.