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目的:探讨肝动脉栓塞化疗术(TOCE加GS)、瘤内无水酒精注射术(PEI)和门静脉介入治疗术(PVE)即3介入治疗,联合特异性肿瘤细胞毒T淋巴细胞(CTLs)的综合序贯疗法在中晚期肝癌治疗中的优越性。方法:127例中晚期肝癌(Ⅱ～Ⅲ期,巨块型或结节型。肝功Child A或B级)患者随机分A、B、C 3组,其中A组52例为治疗组,予综合序贯治疗,B组(45例)、C组(30例)为对照组,分别予TOCE、GS联合CTLs治疗和单纯TOCE加GS治疗,疗程均为2～4个月。结果:A、B、C 3组患者的症状缓解率(%)分别为:76.9、68.9、46.7(P<0.05);12、24个月生存率(%)分别为:71.2、60.0、43.4和57.7、37.8、30.0(P<0.05);中位生存期(月)分别为21.19、14.81、9.83(P<0.05);治疗后外周血T细胞亚群功能变化,A、B组与C组比较差异显著(P<0.05);治疗后AFP(ng/ml)水平均有下降,其中A、B组与C组比较下降差异显著(P<0.05);治疗1年后肝外转移率(%),A、B、C组分别为25.0、26.7、46.7;治疗期间Karnofsky评分变化3组间无显著差异,但A组恢复时间短于B、C组。结论:综合序贯疗法,能提高中晚期肝癌患者1年、2年的生存率、延长生存期。
Objective: To investigate the effect of hepatic arterial chemoembolization (TOCE plus GS), intratumoral alcohol injection (PEI) and portal vein interventional therapy (PVE), 3 interventional therapy combined with specific cytotoxic T lymphocytes (CTLs) Superior sequential therapy in the treatment of advanced liver cancer. Methods: A total of 127 patients with advanced or advanced liver cancer (stage Ⅱ ~ Ⅲ, massive or nodular liver grade Child A or B) were randomly divided into three groups: group A, group B and group C, in which 52 patients in group A were treated with The patients in group B (45 cases) and group C (30 cases) were treated with TOCE, GS combined with CTLs and TOCE plus GS alone. The course of treatment was 2 to 4 months. Results: The remission rate (%) of patients in group A, B and C were 76.9, 68.9 and 46.7 respectively (P <0.05). The survival rates at 12 and 24 months were 71.2, 60.0 and 43.4 57.7, 37.8 and 30.0 respectively (P <0.05). The median survival time was 21.19, 14.81 and 9.83 respectively (P <0.05). The function of T lymphocyte subsets in peripheral blood changed after treatment, (P <0.05). The levels of AFP (ng / ml) decreased after treatment, and there was significant difference between A and B groups and C group (P <0.05) , A, B, C group were 25.0,26.7,46.7; Karnofsky score changes during treatment no significant difference between the three groups, but the recovery time of group A shorter than the B, C group. Conclusion: Integrated sequential therapy can improve the 1-year and 2-year survival rate of patients with advanced liver cancer and prolong their survival.