肝动脉化疗栓塞联合伽玛刀治疗中晚期肝癌疗效分析.docVIP

肝动脉化疗栓塞联合伽玛刀治疗中晚期肝癌疗效分析 　　[摘要] 目的 分析经导管肝动脉化疗栓塞(TACE)联合体部伽玛刀治疗中晚期肝癌的疗效。方法 中晚期肝癌患者72例随机分为治疗组36例和对照组36例,分别采用TACE联合伽玛刀以及常规TACE的方法治疗。结果 术后1个月复查CT,治疗组肿瘤缩小患者有31例,占86.1%;对照组有24例,占66.7%。复查甲胎蛋白(AFP),治疗组AFP值下降大于50%有21例,占58.3%;对照组AFP值下降大于50%有9例,占25%。1年生存率治疗组为80.5%,对照组为58.3%。治疗组有效率较对照组高,两组差异有显著性(P 　　[关键词] 肝癌; 化学栓塞治疗; 放射治疗; 伽玛刀 　　[中图分类号] R735.7 [文献标识码] A [文章编号] 1673-9701(2010)15-37-02 　　 　　Analysis of Transcatheter Arterial Chemoembolization Combined Gamma Knife in Treatment of Advanced Hepatocellular Carcinoma 　　ZHANG Xin1 SHA Xiaofeng2 HUANG Zongya1 DING Hui1 　　1.Image Division Huaian 4th Peoples Hospital;2.Oncology,PLA 82 Hospital,Huaian 223000,China 　　 　　[Abstract] ObjectiveTo analyze the transcatheter hepatic arterial chemoembolization(TACE) of the Commonwealth Department of gamma knife treatment of advanced liver cancer. Methods72 patients with advanced liver cancer patients 36 patients were randomly divided into treatment group and control group,36 cases were used TACE combined gamma knife as well as conventional method of TACE treatment. Resultsin January reviewed CT,tumor shrinkage in patients with the treatment group there were 31 cases,accounting for 86.1% of the control group had 24 cases,accounting for 66.7%. Review Alpha-fetoprotein AFP ,the treatment group AFP value decreased more than 50% of 21,accounting for 58.3%. AFP values of the control group decreased more than 50% of 9,which accounted for 25%. 1-year survival rate of 80.5% in treatment group and control group 58.3%. The treatment group was higher than the control group,differences between the two groups was significant(P 本文为全文原貌 未安装PDF浏览器用户请先下载安装 原版全文 　　2.3 术后1年生存率 　　远期疗效治疗组1年生存率显著高于对照组,见表2。 　　3 讨论 　　目前,肝癌手术切除仍然是最有效的治疗方法,对于失去手术机会的肝癌患者,TACE是目前临床上首选的治疗措施。由于肝癌具有肝动脉和门静脉双重供血,尤其在肿瘤边缘更是如此[3],肝动脉栓塞后,正常肝组织的血供不受到多大影响,这是肝动脉化疗栓塞治疗肝癌取得较好疗效的基础,但是由于门静脉参与了肿瘤的部分供血,单独肝动脉栓塞并不能使肿瘤发生完全性梗死,结果造成栓塞后肿瘤内一部分细胞、肿瘤包膜内一些侵润细胞以及小的肝内转移细胞仍然存活[4]。这就使TACE的疗效受到明显的影响。 　　全身伽玛刀治疗作为一种填充式三维适形放疗,是以钴60为放射源,根据几何聚焦原理,将30束γ射线从