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目的:探讨经肝动脉化疗栓塞(TACE)联合微波消融(MWA)及~(125)I放射性粒子植入治疗小肝癌的安全性和疗效。方法:19例行TACE治疗小肝癌患者,术后1个月复查肝功能、AFP及上腹部CT平扫+增强扫描,根据检查结果联合MWA及~(125)I放射性粒子植入治疗,联合治疗3个月后再次复查肝功能、AFP及上腹部CT平扫+增强扫描,采用m RECIST标准评价其疗效。结果:19例患者共行TACE治疗19次,TACE术后1个月病灶完全缓解(CR)6例、部分缓解(PR)13例,完全缓解率31.5%,13例PR患者联合MWA或MWA+~(125)I放射性粒子治疗后3个月CR 10例、PR 3例。TACE术后1个月3例患者AFP值降至正常,联合治疗后3个月,全组16例患者AFP值降至正常,另3例患者AFP值较术前均明显下降。全部病例均未发生严重并发症。结论:TACE联合MWA及~(125)I放射性粒子植入治疗小肝癌能明显提高其疗效,并且具有创伤小、并发症少等优点。
Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) and 125I radioactive seed implantation in the treatment of small hepatocellular carcinoma. Methods: TACE was performed in 19 patients with small hepatocellular carcinoma (HCC). One month after operation, liver function, AFP and CT scan of upper abdomen were compared. Combined with MWA and 125I radioactive seed implantation, Three months later, the liver function, AFP and CT scan of upper abdomen were compared again, and m RECIST criteria was used to evaluate the efficacy. Results: Nineteen patients were treated with TACE in 19 cases. Six months after TACE, 6 cases were completely relieved (CR), 13 cases were partially relieved (PR), and the complete remission rate was 31.5%. Thirteen cases of PR combined with MWA or MWA + (125) I 3 months after treatment of radioactive particles CR 10 cases, PR 3 cases. Three months after TACE, the AFP values of 3 patients dropped to normal. At 3 months after the combination therapy, the AFP values of 16 patients in the whole group dropped to normal, and the other 3 patients’ AFP values were significantly lower than those before operation. No serious complications occurred in all cases. CONCLUSION: TACE combined with MWA and ~ (125) I radioactive particle implantation can significantly improve the curative effect of small hepatocellular carcinoma, and has the advantages of less trauma and fewer complications.