放射性粒子植入联合高能聚焦超声治疗肝内乏血供肿瘤的疗效
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摘要
目的分析放射性粒子植入联合高能聚焦超声(HIFU)治疗肝内乏血供肿瘤(PBSH)的疗效。方法收集2012年11月至2016年6月在我院收治且确诊的PBSH患者112例,按入院顺序随机分为2组:观察组62例和对照组50例。观察组给予放射性粒子植入联合HIFU治疗,对照组给予HIFU治疗。记录两组治疗前后的基质金属蛋白酶-9(matrix metallopeptidase 9,MMP-9)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、甲胎蛋白(alpha fetoprotein,AFP)及肝功能,并记录疗效评定、不良反应及随访生存状况。结果两组治疗前的MMP-9、VEGF、AFP和肝功能均差异无统计学意义(P>0.05)。治疗后,两组的MMP-9、VEGF、AFP、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)和总胆红素(total bilirubin,TBil)均明显降低(P<0.05);与对照组比,观察组的MMP-9、VEGF、AFP、ALT、AST和TBil降低明显(P<0.05)。与对照组比,观察组的完全缓解(complete remission,CR)、稳定(stable disease,SD)例数较多,进展(progressive disease,PD)例数较少(P<0.05),两组总有效率相当(P>0.05)。观察组50%生存时间为38个月,对照组50%生存时间为30个月,与对照组比,观察组的生存时间较长(χ~2=5.703,P=0.017)。结论放射性粒子植入联合HIFU可用于治疗PBSH。
引文
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[3]Zhou DY,Qin J,Huang J,et al.Zoledronic acid inhibits infiltration of tumor-associated macrophages and angiogenesis following transcatheter arterial chemoembolization in rat hepatocellular carcinoma models.Oncol Lett,2017,14:4078-4084.
[4]Wu L,Zhang YS,Ye ML,et al.Overexpression and correlation of HIF-2α,VEGFA and EphA2 in residual hepatocellular carcinoma following high-intensity focused ultrasound treatment:Implications for tumor recurrence and progression.Exp Ther Med,2017,13:3529-3534.
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[6]曹贵文,杜苗苗,崔新江,等.TACE联合125I放射性粒子植入序贯治疗近心旁原发性肝细胞肝癌效果观察.山东医药,2017,57:55-57.
[7]Wakayama K,Kamiyama T,Yokoo H,et al.Huge hepatocellular carcinoma greater than 10cm in diameter worsens prognosis by causing distant recurrence after curative resection.JSurg Oncol,2017,115:324-329.
[8]张大为,何津,吴会静,等.高强度聚焦超声联合125I粒子植入治疗中晚期原发性肝癌临床观察.海南医学,2017,28:37-40.
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