摘要
目的 探讨评价精细肝动脉栓塞化疗术(TACE)联合射波刀治疗不可切除肝恶性肿瘤的安全性和有效性。方法 选取晚期不可切除肝恶性肿瘤患者46例,将其分为对照组(31例)和联合组(15例)。对照组采用单纯TACE方案或单纯射波刀方案,联合组采用精细TACE+射波刀治疗方案,TACE术中均采用微导管超选择后锥形束CT验证后栓塞。观察无进展生存时间(PFS)、总生存期(OS)、不良反应(CTCAE 5.0)、白蛋白-胆红素评分(ALBI)、D-2聚体及卡氏评分(KPS)。结果 联合组PFS为10.13(2.0,27.0)个月,高于对照组的4.70(1.0,18.0)个月,差异有统计学意义(f=8.131, P=0.010)。联合组客观缓解率(ORR)和疾病控制率(DCR)分别为47.7%和86.7%,均高于对照组的38.7%和74.2%,差异无统计学意义(P=0.500)。整体中Ⅰ、Ⅱ和Ⅲ级不良反应发生比例分别为13.7%、5.8%、2.4%。对照组与联合组的AFP、ALBI、D-2等相关指标比较,差异均无统计学意义(P>0.05)。结论 精细TACE+射波刀治疗对不可切除肝恶性肿瘤的疗效优于单纯TACE或单纯射波刀治疗,且安全性较好。
Objective To evaluate the safety and efficacy of fine TACE combined with the cyberknife in the treatment of unre‐sectable liver malignant tumors.Methods Forty-six patients with advanced unresectable hepatic malignancies were divided into control group(31 cases)and combination group(15 cases).The patients in control group were treated with TACE alone or‐with cyberknife alone,while,patients in the combined treatment group were treated with TACE+cyberknife.During TACE sur‐gery,embolization was performed after microcatheter superselection and conical beam CT verification.Progression-free survival(PFS),overall survival(OS),adverse reactions(CTCAE5.0),albumin-bilirubin score(ALBI),D-2 polymers and quality of life(KPS)scores were observed.Results The PFS of the combined group was 10.13(2.0,27.0)months,higher than 4.70(1.0,18.0)months of the control group,and the difference was statistically significant(f=8.131,P=0.010).The ORR and DCR of the combined group were 47.7%and 86.7%,respectively,higher than 38.7%and 74.2%of the control group,but the differ‐ence was not statistically significant(P=0.500).The proportion of gradeⅠ、ⅡandⅢadverse reactions was 13.7%、5.8%and 2.4%,respectively.There was no significant difference in AFP,ALBI,D-2 and other related indexes between control group and combination group(P>0.05).Conclusion The efficacy of the combination group(TACE+cyberknife)in the treatment of unre‐sectable hepatic malignancies is better than that of the reference group with TACE or cyberknife alone,and the safety is better.
作者
王冠武
吕庆亮
唐世伟
李文军
刘泉
蒋楠
贺光辉
孔铭新
李艳
蔡佳
WANG Guanwu;LYU Qingliang;TANG Shiwei;LI Wenjun;LIU Quan;JIANG Nan;HE Guanghui;KONG Mingxin;LI Yan;CAI Jia(Department of Interventional Radiology,Weifang People's Hospital,Weifang 261000,China;Department of Radiotherapy,Sunshine Union Hospitalof Weifang City,Weifang 261000,China;Department of Intervention,the Second People's Hospital of Weifang City,Weifang 261000,China)
出处
《医学影像学杂志》
2024年第7期61-64,共4页
Journal of Medical Imaging
基金
山东省潍坊市卫生健康委科研项目(编号:WFWSJK-2021-185)。
关键词
肝恶性肿瘤
射波刀
安全性
有效性
Hepatic malignant tumor
Cyberknife
Security
Effectiveness
