氩氦刀冷冻消融联合经导管肝动脉化疗栓塞治疗肝细胞癌
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摘要
目的探讨氩氦刀冷冻消融联合经导管肝动脉化疗栓塞(TACE)治疗肝细胞癌的临床疗效和不良反应。方法 56例肝细胞癌患者随机分为2组,对照组27例单纯行氩氦刀冷冻消融治疗,观察组29例行氩氦刀冷冻消融联合TACE治疗。比较观察2组的血清甲胎蛋白(AFP)水平、近期疗效、1 a生存率及不良反应。结果治疗后,观察组患者AFP水平显著低于对照组,差异有统计学意义(P<0.05)。观察组有效率(69.0%)明显高于对照组(40.7%),差异有统计学意义(P<0.05)。观察组1 a生存率(79.3%)明显高于对照组(51.9%),差异有统计学意义(P<0.05)。2组不良反应比较差异无统计学意义(P>0.05),均可以耐受。结论氩氦刀冷冻消融联合TACE治疗肝细胞癌的疗效优于单纯氩氦冷冻治疗,且安全性良好,是无法手术切除肝细胞癌患者的理想选择。
Objective To investigate the efficacy of argon helium cryoablation combined with transcatherter arterial chemoembolization(TACE) in the treatment of hepatocellular carcinoma. Methods Fifty-six patients with hepatocellular carcinoma were selected and randomly divided into two groups: 27 cases of the control group were treated with argon helium cryoablation; 29 cases of the observation group were treated with argon helium cryoablation combined with TACE. The serum alpha-fetoprotein(AFP) level,short-term efficacy,1-year survival rate and adverse reactions were observed. Results The AFP level in the control group was significantly lower than that in the control group after the treatment(P<0.05). The effective rate in the observation group(69.0%) was significantly higher than that in the control group(40.7%,P<0.05). The 1-year survival rate in the control group(79.3%) was significantly higher than that in the control group(51.9%,P<0.05). All the adverse reactions can be tolerated,the difference was not statistically significant between the two groups(P>0.05). Conclusion Argon helium cryoablation combined with TACE is more effective than argon-nitrogen cryoablation in the treatment of hepatocellular carcinoma,which is an ideal choice for inoperable patients.
Objective To investigate the efficacy of argon helium cryoablation combined with transcatherter arterial chemoembolization(TACE) in the treatment of hepatocellular carcinoma. Methods Fifty-six patients with hepatocellular carcinoma were selected and randomly divided into two groups: 27 cases of the control group were treated with argon helium cryoablation; 29 cases of the observation group were treated with argon helium cryoablation combined with TACE. The serum alpha-fetoprotein(AFP) level,short-term efficacy,1-year survival rate and adverse reactions were observed. Results The AFP level in the control group was significantly lower than that in the control group after the treatment(P<0.05). The effective rate in the observation group(69.0%) was significantly higher than that in the control group(40.7%,P<0.05). The 1-year survival rate in the control group(79.3%) was significantly higher than that in the control group(51.9%,P<0.05). All the adverse reactions can be tolerated,the difference was not statistically significant between the two groups(P>0.05). Conclusion Argon helium cryoablation combined with TACE is more effective than argon-nitrogen cryoablation in the treatment of hepatocellular carcinoma,which is an ideal choice for inoperable patients.
引文
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[9] CHEN YY,YEN HH,CHOU KC,et al.Thalidomide-based multidisciplinary treatment for patients with advanced hepatocellular carcinoma:a retrospective analysis[J].World J Gastroenterol,2012,18(5):466-471.
[10] HAO XJ,LI JP,JIANG HJ,et al.CT assessment of liver hemodynamics in patients with hepatocellular carcinoma after argon-helium cryoablation[J].Hepatobiliary Pancreat Dis Int,2013,12(6):617-621.
[11] HATOOKA M,KAWAOKA T,AIKATA H,et al.Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy and Sorafenib in Patients with Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization[J].Anticancer Res,2016,36(7):3523-3529.
[12] LEE MH,KIM SU,KIM DY,et al.Early on-treatment predictions of clinical outcomes using alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with advanced hepatocellular carcinoma[J].J Gastroenterol Hepatol,2012,27(2):313-322.
[13] ZHANG YF,WEI W,GUO ZX,et al.Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus[J].Jpn J Clin Oncol,2015,45(9):837-843.
[14] HUANG C,ZHUANG W,FENG H,et al.Analysis of therapeutic effectiveness and prognostic factor on argon-helium cryoablation combined with transcatheter arterial chemoembolization for the treatment of advanced hepatocellular carcinoma[J].J Cancer Res Ther,2016,12(Supplement):C148-C152.
[2] OGAWA K,KAMIMURA K,WATANABE Y,et al.Effect of double platinum agents,combination of miriplatin-transarterial oily chemoembolization and cisplatin-hepatic arterial infusion chemotherapy,in patients with hepatocellular carcinoma:Report of two cases[J].World J Clin Cases,2017,5(6):238-246.
[3] 中国抗癌协会肝癌专业委员会.原发性肝癌诊断标准[J].中华肝脏病杂志,2000,8(3):135.
[4] LEE S,KIM KM,LEE SJ,et al.Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma:comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study[J].Acta Radiol,2017,58(2):131-139.
[5] WANG Y,SHEN Y.Unresectable hepatocellular carcinoma treated with transarterial chemoembolization:clinical data from a single teaching hospital[J].Int J Clin Exp Med,2013,6(5):367-371.
[6] 陈亚丽,王蜂.经肝动脉灌注化疗栓塞治疗中晚期肝癌156例观察[J].重庆医学,2007,36(11):1096-1097.
[7] NAGAMATSU H,SUMIE S,NIIZEKI T,et al.Hepatic arterial infusion chemoembolization therapy for advanced hepatocellular carcinoma:multicenter phase Ⅱ study[J].Cancer Chemother Pharmacol,2016,77(2):243-250.
[8] TAKAYASU K.Transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma:recent progression and perspective[J].Oncology,2013,84 Suppl 1:28-33.
[9] CHEN YY,YEN HH,CHOU KC,et al.Thalidomide-based multidisciplinary treatment for patients with advanced hepatocellular carcinoma:a retrospective analysis[J].World J Gastroenterol,2012,18(5):466-471.
[10] HAO XJ,LI JP,JIANG HJ,et al.CT assessment of liver hemodynamics in patients with hepatocellular carcinoma after argon-helium cryoablation[J].Hepatobiliary Pancreat Dis Int,2013,12(6):617-621.
[11] HATOOKA M,KAWAOKA T,AIKATA H,et al.Comparison of Outcome of Hepatic Arterial Infusion Chemotherapy and Sorafenib in Patients with Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization[J].Anticancer Res,2016,36(7):3523-3529.
[12] LEE MH,KIM SU,KIM DY,et al.Early on-treatment predictions of clinical outcomes using alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with advanced hepatocellular carcinoma[J].J Gastroenterol Hepatol,2012,27(2):313-322.
[13] ZHANG YF,WEI W,GUO ZX,et al.Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus[J].Jpn J Clin Oncol,2015,45(9):837-843.
[14] HUANG C,ZHUANG W,FENG H,et al.Analysis of therapeutic effectiveness and prognostic factor on argon-helium cryoablation combined with transcatheter arterial chemoembolization for the treatment of advanced hepatocellular carcinoma[J].J Cancer Res Ther,2016,12(Supplement):C148-C152.