【摘要】 目的:研究TACE、PVE、HIFU治疗原发性肝癌的临床疗效。方法:对不能手术的原发性肝癌68例分成2组,观察组先行TACE治疗,1周后行PVE治疗,TACE+PVE每2个月进行1周期,2～3周期后再行HIFU治疗,以TACE+PVE治疗作为对照,分别统计两组疗效、副作用、生存率。结果:观察组32例共TACE67次,平均2.1次/例,PVE64次,平均2次/例,HIFU99次,平均3.1次/例;对照组36例TACE78次,平均2.2次/例,PVE74次,平均2.1次/例,观察组与对照组总有效率分别为71.9%(23/32)、44.4%(16/36),两组比较差异有显著性(P<0.05);合并门静脉癌栓经治疗后癌栓缩小>1/2者,观察组为69.2%(9/13),对照组21.4%(3/14)(P<0.05);治疗后AFP转阴或滴度下降>1/2者分别为66.7%(16/24)、37.0%(10/27)(P<0.05);观察组6、12、18、24个月生存率分别为76%、60%、40%、20%,对照组为50%、33.3%、16.7%、2.8%(P<0.05)。结论:TACE+PVE+HIFU治疗PHC可以提高肿瘤局部控制率,提高生存质量,延长生存期,是晚期PHC较为有效的治疗方法之一。更多还原

【Abstract】 Objective:To study the clinical curative effect of TACE,PVE,HIFU therapy for primary hepatic carcinoma(PHC).Methods:Sixty-eight inoperative PHC patients were divided randomly into two groups.The observation group was treated with TACE first,then PVE a week later,and TACE+PVE was given every two months as a cycle.After 2-3 cycles HIFU was given.The control group was given TACE+PVE.The curative effect,relative side effects and survival rate were recorded respectively.Results:In the observation group,32 patients were given TACE 67 times,PVE 64 times,and HIFU 99 times;averagely 2.1,2 and 3.1 times per case respectively.In control group,36 patients were given TACE 78 times,PVE 74 times,averagely 2.2 and 2.1 times per case.The total response rate in two groups was 71.9%(23/32)and 44.4%(16/36)respectively.The difference between the two groups was significant(P<0.05).In the patients with portal vein tumor thrombus,the thrombus reduced over 1/2 after treatment in the observation group was 69.2%(9/13)and the control group 21.4%(3/14)(P<0.05).The AFP reversion or decrease over 1/2 was 66.7%(16/24)in the observation group and 37.0%(10/27)(P<0.05)in the control group.The 6-,12-,18-and 24-month survival rate were 76%,60%,40%,20% and 50%,33.3%,16.7%,2.8%,respectively(P<0.05).Conclusion:The treatment of TACE+PVE+HIFU sequential therapy for PHC can increase local control rate of tumor,improve life quality,prolong survival duration,and is an effective treatment on advanced PHC.更多还原