氩氦刀冷冻消融术联合节拍化疗治疗巨块型肝癌临床探究.doc

氩氦刀冷冻消融术联合节拍化疗治疗巨块型肝癌临床探究 　　【摘要】 目的 研究氩氦刀冷冻消融术联合节拍化疗治疗巨块型肝癌的临床疗效。方法 60例巨块型肝癌患者， 随机分为观察组和对照组， 每组30例。观察组在氩氦刀冷冻消融术基础上联合节拍化疗；对照组单纯给予氩氦刀冷冻消融术治疗。比较两组的治疗效果。结果 观察组患者的临床治疗总有效率（50.0%）高于对照组（23.3%）， 差异有统计学意义（P0.05）。结论 氩氦刀冷冻消融术联合节拍化疗是治疗巨块型肝癌的一种安全有效方法， 值得推广 【关键词】 巨块型肝癌；氩氦刀；冷冻消融术；节拍化疗 DOI：10.14163/j.cnki.11-5547/r.2016.33.017 Clinical research of argon-helium knife cryoablation combined with metronomic chemotherapy in the treatment of massive liver cancer WANG Liu-fei， HONG Feng-juan， BI Xiang-jun， et al. Department of Oncology， Guangdong Yangchun City People’s Hospital， Yangchun 529600， China 【Abstract】 Objective To research clinical effect by argon-helium knife cryoablation combined with metronomic chemotherapy in the treatment of massive liver cancer. Methods A total of 60 patients with massive liver cancer were randomly divided into observation group and control group， with 30 cases in each group. The observation group received combined metronomic chemotherapy in addition to argon-helium knife cryoablation， and the control group received argon-helium knife cryoablation alone for treatment. Curative effects were compared between the two groups. Results The observation group had higher total effective ate （50.0%） than the control group （23.3%）， and the difference had statistical significance （P0.05）. Conclusion Combination of argon-helium knife cryoablation and metronomic chemotherapy is a safe and effective method in treating massive liver cancer and worth clinical promotion. 【Key words】 Massive liver cancer； Argon-helium knife； Cryoablation； Metronomic chemotherapy 肝癌是我??最常见肿瘤之一， 由于该病起病隐匿， 就诊时多呈巨块型肝癌（巨块型肝癌肿瘤直径10 cm的肝癌）。巨块型肝癌患者生活质量差， 生存时间短， 治疗手段有限。肿瘤局部消融术近年广泛应用于肝癌治疗， 针对巨块型肝癌氩氦刀冷冻消融术具有独特优势， 如消融范围大、效果肯定、微创等优点。大量的临床治疗结果证实根治性氩氦刀冷冻消融治疗为临床肿瘤治疗提供了新的有效治疗手段[1， 2]。但是氩氦刀冷冻消融治疗也存在不足， 如肿瘤过大、肿瘤边缘不规则等导致治疗不彻底， 局部炎性因子可能刺激残留癌组织继续生长等。所谓节拍化疗， 也称之为抗新生血管化疗， 是指低剂量、短间歇、频繁密集给药的化疗方法。节拍化疗具有毒副作用小、患者容易接受等优点。相关临床研究表明[3-7]， 进行节拍化疗是所采用的临床药物能够在浓度剂量较低的条件下依旧能够保有药物本身所具备的强抗血管生成效用， 因此， 临床开展节拍化疗时， 也