论文部分内容阅读
目的评估射频消融(RFA)联合经导管肝动脉栓塞化疗(TACE)、超声引导下经皮穿刺门静脉化疗(PVC)治疗原发性肝癌的临床疗效。方法将60例原发性肝癌患者随机分为综合1组、综合2组及对照组,每组20例。综合1组先行TACE治疗,一周内行RFA+PVC;综合2组在彩色多普勒超声引导下在病灶区行RFA,结束后进行PVC治疗,一周内行TACE。对照组单纯使用RFA治疗1~3个疗程,具体次数依据彩色多普勒超声所显示的血流情况定。比较各组患者治疗前后肝功能、AFP阳性率、肿瘤直径及1年、2年生存率。结果 3组患者均按计划完成相应治疗,并全部获得随访。综合1组和综合2组治疗后肝功能恢复、AFP阳性率及肿瘤缩小程度方面明显优于对照组(P<0.05)。综合1组、综合2组及对照组患者1、2年生存率分别为90%、65%,80%、55%和40%、20%,综合1组、综合2组生存率明显高于对照组(P<0.05)。结论对于不能手术切除的肝癌患者,综合治疗是延长患者生存期、控制肿瘤进展的有效治疗手段。
Objective To evaluate the clinical efficacy of radiofrequency ablation (RFA) in combination with transcatheter arterial chemoembolization (TACE) and percutaneous portal vein chemotherapy (PVC) guided by ultrasound in the treatment of primary liver cancer. Methods Sixty patients with primary liver cancer were randomly divided into 1 group, 2 groups and control group, 20 cases in each group. The first group was treated with TACE in one week and RFA + PVC was performed in one week. RFA was performed in the lesion area under the guidance of color Doppler ultrasound in the two groups. PVC treatment was performed after the end of the procedure. TACE was performed in one week. The control group was treated with RFA only for 1 to 3 courses, the exact number of which was determined according to the blood flow displayed by color Doppler ultrasound. The liver function, AFP positive rate, tumor diameter and 1-year and 2-year survival rates were compared between the two groups before and after treatment. Results All 3 patients completed the corresponding treatment according to plan and all were followed up. Compared with the control group (P <0.05), the liver function recovery, AFP positive rate and the extent of tumor shrinkage in the integrated 1 and 2 groups were significantly better than those in the control group. The overall 1-year and 2-year survival rates were 90%, 65%, 80%, 55%, 40% and 20% respectively in the comprehensive group 1 and the comprehensive group 2 and the control group. The overall survival rate of the combined group 1 and group 2 was significantly higher than that of the control group Group (P <0.05). Conclusion For patients with unresectable liver cancer, comprehensive treatment is an effective treatment to prolong survival and control tumor progression.