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目的:回顾性分析瘤内无水酒精注射联合体外高频热疗治疗原发性肝细胞癌的疗效及毒副反应。方法:纳入经确诊的瘤灶最大径≤5cm、总数≤3个且无肝外病灶的原发性肝细胞癌患者42例。各病灶行B超引导下无水酒精注射共3~4次(1次/周),注射后隔日行局部高频热疗1小时,温度41℃~43℃。结果:全组中位随访时间32个月,疗后AFP下降率为95.2%、总客观缓解率为61.9%、中位无疾病进展生存期34个月、中位生存期40个月。肝内单发病灶较2~3个病灶的患者有生存优势(P<0.05)。全组治疗后1度及2度肝功能损伤发生率为42.8%,1度及2度疼痛为38%,1度发热为31%。结论:该联合方案对治疗瘤灶最大径≤5cm、总数≤3个且无肝外病灶的原发性肝细胞癌的疗效较好且毒副反应较小。
Objective: To retrospectively analyze the curative effect and toxicity of intratumoral alcohol injection and in vitro high frequency hyperthermia in the treatment of primary hepatocellular carcinoma. Methods: Forty-two patients with primary hepatocellular carcinoma without any extrahepatic lesions were enrolled in the study. Each lesion underwent B-ultrasound guided injection of anhydrous alcohol for 3 to 4 times (once a week). Local high-frequency hyperthermia was performed for 1 hour every other day at the temperature of 41 ° C to 43 ° C after injection. Results: The median follow-up time was 32 months. After treatment, AFP decreased 95.2% and total objective response rate was 61.9%. The median progression-free survival was 34 months and the median survival was 40 months. Single intrahepatic lesions than 2 to 3 lesions in patients with survival advantage (P <0.05). The incidence of hepatic injury at 1 degree and 2 degrees after the treatment was 42.8% in the whole group, 38% at 1 degree and 2 degrees, and 31% at 1 degree. Conclusion: The combination regimen is effective and less toxic to primary hepatocellular carcinoma for the treatment of maximal diameter ≤5cm, total ≤3 and no extrahepatic lesions.