【作者】 蒋勇；

【导师】 马金良；

【作者基本信息】 安徽医科大学 ， 外科学（普外）， 2020， 硕士

【摘要】 目的:比较门静脉置入I¹²⁵粒子和TACE联合治疗与外放疗和TACE联合治疗对不可切除的肝癌合并门脉癌栓患者的疗效。方法:本研究回顾性分析了70例无法行手术切除的肝癌合并门静脉癌栓的患者的临床资料,将各资料分为两组:一组（35例）患者接受了门静脉置入I¹²⁵粒子和TACE联合治疗,另一组（35例）患者接受了外放疗和TACE联合治疗,通过对两组患者的生存期进行对比,来判断两种不同治疗方法对患者生存期是否有影响,次要终点是肿瘤反应和不良反应。同时对影响患者生存期的因素进行单因素及多因素的生存分析。结果:门静脉置入I¹²⁵粒子和TACE联合治疗组的中位生存期为15.00个月[95%置信区间（CI）13.45-16.55],外放疗和TACE联合治疗组的中位生存期为13.00个月[95%置信区间（CI）8.53-17.47],两组生存期的差异没有统计学意义（P=0.570）。单因素和多因素的生存分析也提示两组生存期的差异无统计学的意义。在不良反应方面,门静脉置入I¹²⁵粒子与TACE联合治疗组的不良反应相对较少,且两组之间对比有统计学意义（P<0.001）,提高了患者的生存质量。结论:实验组与对照组在总生存期上的差异无统计学意义,但门静脉置入I¹²⁵粒子与TACE联合治疗组出现的不良反应相对较少,可提高患者治疗后的生存质量。更多还原

【Abstract】 Objective: To compare the efficacy and safety of transarterial chemoembolization combined with endovascular Implant Iodin-125 seed and transarterial chemoembolization combined with external radiotherapy for the inoperable patient of hepatic carcinoma with portal vein tumor thrombus.Methods : This study retrospectively analyzed 70 cases of unable to surgical resectio n of hepatic carcinoma with portal vein tumor thrombus in patients with clinical data.The data can be divided into two groups: a group(35 cases)patients accepted transarterial chemoembolization combined with endovascular Implant Iodin-125 seed,another group(35 cases)patients accepted transarterial chemoembolization combined with external radiotherapy.Comparing two groups of patients’ survival,to determine whether two different treatment for the patient survival,a secondary end point was the tumor response and adverse reactions.At the same time,univariate and multi-variate survival analysis were performed.Results :The overall survival in TACE combined with iodine 125 seed group better than than in TACE combined with external radiotherapy group(15 month vs 13 month),but it was not significant(P=0.570).The adverse events in the TACE combined with iodine 125 seed group is less significantly than in the TACE combined with external radiotherapy group(P<0.001).The first group can improve the life quality of patiencts.Conclusion : The Survival benfit in TACE combined with iodine 125 seed group was not significantly better than than in TACE combined with external radiotherapy group,but the adverse events of the TACE combined with iodine 125 seed gtoup was significantly less.It improves the quality of life after treatment.更多还原