摘要
目的探讨吉西他滨热化疗灌注联合TAE治疗原发性肝细胞癌(PHCC)的价值。方法将96例PHCC患者随机分为2组,A组采用热化疗灌注与TAE联合治疗,B组采用常温下化疗灌注与TAE联合治疗;比较治疗前、治疗后3天及30天肝、肾功能变化,治疗前、治疗后7天免疫功能变化;治疗后30天行CT平扫和多期增强扫描,依据RECIST标准比较两组临床有效率;每间隔30天重复治疗1次,第3次介入治疗后进行随访,比较两组总生存期。结果治疗后3天A、B两组丙氨酸转氨酶(ALT)及谷草转氨酶(AST)较治疗前均升高(P<0.05),且B组高于A组(P<0.01),但治疗后30天较治疗前无变化,而A、B两组肾功能治疗前后无明显变化。近期疗效评价A组临床有效率75.00%(36/48),B组39.58%(19/48),两组差异有统计学意义(P<0.01);A组治疗后免疫功能提高,而B组治疗后下降。A组中位生存时间为24.0个月,B组中位生存时间为19.0个月(P<0.01)。结论热化疗灌注联合TAE是治疗PHCC的有效方法,且对肝功能影响仅为一过性的。
Objective To assess the therapeutic effect of transcatheter arterial infusion of heated gemcitabine combined with transcatheter arterial embolization （TAE） in treatment of primary hepatocellular carcinoma（PHCC）. Methods Ninty-six patients with PHCC were randomly divided into 2 groups. Patients in group A underwent transcatheter arterial infusion of heated gemcitabine combined with TAE, while in group B underwent conventional infusion combined with TAE. Liver function and renal function were measured before treatment, as well as 3 days and 30 days after treatment. Immune function was measured before treatment and 7 days after treatment. At the same time, plain and enhanced CT scan was performed, and the total efficiency was evaluated by RECIST. The therapy was repeated with interval of 30 days. Follow-up was performed after the third treatment, and patient’s survival periods were observed. Results Alanine aminotransferase （ALT） and aspartate aminotransferase （AST） of group A and group B were higher 3 days after treatment than before treatment （all P〈0.05）, but there was no statistical difference after 30 days. No significant difference of renal function was found in the two groups. In group A, the total efficiency was 75.00% （36/48）, and that of group B was 39.58% （19/48, P〈0.01）. In group A, the immunity state of patients were improved after treatment, but that of group B decreased. The median survival time of group A and group B was 24.0 months and 19.0 months （P〈0.01）, respectively. Conclusion Transcatheter arterial infusion of heated gemcitabine combined with TAE is effective for the treatment of primary hepatocellular carcinoma, which has only temporary influence on the liver function.
出处
《中国介入影像与治疗学》
CSCD
2013年第3期142-146,共5页
Chinese Journal of Interventional Imaging and Therapy
关键词
肝肿瘤
灌注
化学栓塞
治疗性
Liver neoplasms
Perfusion
Chemoembolization, therapeutic
