摘要
目的 对比碘化油肝动脉化疗栓塞(C-TACE)与载药微球肝动脉化疗栓塞(D-TACE)联合局部热消融治疗巨块型肝癌的疗效。方法 选择2018年4月至2021年6月在南阳市第一人民医院就诊的巨块型肝癌患者72例,以随机数字表法分为研究组36例,对照组36例。对照组采用局部热消融联合C-TACE治疗,研究组采用局部热消融联合D-TACE治疗。对比2组临床疗效、肿瘤标志物、肝功能、血清学指标、血流灌注指标、不良反应,术后随访2年,对比2组无进展生存期(PFS)。结果 研究组疾病控制率(DCR)、客观缓解率(ORR)比对照组高(P<0.05)。术后3个月,2组甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)水平均降低(P<0.05),且研究组更低;2组丙氨酸转氨酶(ALT)均升高(P<0.05),而研究组低于对照组;2组白蛋白(ALB)均降低(P<0.05),而研究组高于对照组(P<0.05);2组表皮生长因子受体(EGFR)、血管内皮生长因子(VEGF)、胸腺激酶1(TK1)水平均降低(P<0.05),且研究组更低;2组血容量(BV)、血流量(BF)均降低(P<0.05),且研究组更低;2组对比剂平均通过时间(MTT)均升高(P<0.05),且研究组更高。研究组不良反应总发生率比对照组低(P<0.05)。术后随访2年,2组各失访1例,随访率为97.22%,研究组中位PFS为15.41个月(95%CI:7.02~23.19),对照组中位PFS为12.34个月(95%CI:6.16~22.30),研究组PFS曲线优于对照组(P<0.05)。结论 局部热消融联合D-TACE可改善巨块型肝癌患者肝功能、血流灌注情况,疗效显著,降低肿瘤标志物,调节血清EGFR、VEGF、TK1表达,安全可靠,且可延长中位PFS。
Objective To compare the curative efficacy of conventional transcatheter arterial chemoembolization(C-TACE)and drug-eluting bead transcatheter arterial chemoembolization(D-TACE)combined with local thermal ablation in the treatment of massive hepatocellular carcinoma(HCC).Methods A total of 72 patients with massive HCC,who were admitted to the Nanyang Municipal First People′s Hospital of China from April 2018 to June 2021,were enrolled in this study.By using random number table method,the patients were divided into study group(n=36)and control group(n=36).The patients of the control group were treated with local thermal ablation combined with C-TACE,while the patients of study group were treated with local thermal ablation combined with D-TACE.The clinical efficacy,tumor markers,liver function,serological indicators,blood perfusion indexes,and adverse reactions were compared between the two groups.All patients were followed up for two years.The progression-free survival(PFS)were compared between the two groups.Results The disease control rate(DCR)and objective response rate(ORR)in the study group were higher than those in the control group(P<0.05).At 3 months after operation,the levels of alpha-fetoprotein(AFP)and prothrombin induced by Vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)were decreased in both groups(P<0.05),which in the study group were obviously lower than those in the control group(P<0.05);the alanine aminotransferase(ALT)level was increased in both groups,which in study group was lower than that in the control group(P<0.05);the albumin(ALB)level was decreased in both groups(P<0.05),which in the study group was higher than that in the control group(P<0.05);the epidermal growth factor receptor(EGFR),vascular endothelial growth factor(VEGF)and thymokinase 1(TK1)levels were decreased in both groups(P<0.05),which in the study group were lower than those in the control group;the blood volume(BV)and blood flow(BF)were decreased in both groups(P<0.05),which in the study group was lower than those in the c
作者
韩廷超
王忠
申梦圆
HAN Tingchao;WANG Zhong;SHEN Mengyuan(Department of Radiology,Nanyang Municipal First People's Hospital,Nanyang,Henan Province 473000,China)
出处
《介入放射学杂志》
CSCD
北大核心
2024年第9期989-994,共6页
Journal of Interventional Radiology
基金
河南省医学科技攻关计划项目(LHGJ20200902)。
关键词
载药微球
局部热消融
肝动脉化疗栓塞
巨块型肝癌
临床疗效
安全性
生存分析
drug-eluting bead
local thermal ablation
transcatheter arterial chemoembolization
massive hepatocellular carcinoma
clinical effect
safety
survival analysis
