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目的 评价CT导引下 ,经皮穿刺热化疗治疗肺、肝恶性肿瘤的价值。方法 2 1例肝癌、肺癌和肝、肺转移癌患者行肿块热化疗。将化疗药物加热至 5 5～ 6 0℃ ,在CT引导下注入肿块内 ,注入量根据V =4/ 3π(r +0 .5 )cm3 t适当增减。重复治疗 2～ 5次 ,并依治疗前后CT扫描密度和大小的变化以及生化指标、生存期作为疗效观察标准 ,治疗效果分为五级 :效佳、显效、有效、效差、无效。结果 效佳 6例 ,显效 9例 ,有效 3例 ,效差 2例 ,无效 1例 ,随访观察时间为 36个月 2 0例 ,病员生存时间 8～ 2 2个月 ,平均生存时间 16个月 ,1例病员结合肝动脉栓塞治疗 ,存活 2 8个月仍健在。治疗总有效率为 95 .2 %。结论 CT导引下经皮穿刺热化疗是治疗肺、肝恶性肿瘤的有效方法 ,尤其适合于不能手术切除的病人 ,结合肝动脉栓塞可提高疗效。
Objective To evaluate the value of percutaneous thermal chemotherapy in the treatment of lung and liver malignancies under CT guidance. Methods Twenty-one patients with hepatocellular carcinoma, lung cancer, metastases from liver and lung were treated with thermochemotherapy. The chemotherapeutic drugs were heated to 550-600°C and injected into the tumor under the guidance of CT. The injection volume was appropriately increased and decreased according to V = 4 / 3π(r + 0.5) cm3 t. Repeat treatment 2 to 5 times, and according to the changes in the density and size of the CT scan before and after treatment and biochemical indicators, survival period as the observation standard of efficacy, the treatment effect is divided into five levels: effective, effective, effective, effective, invalid. The results were good in 6 cases, markedly effective in 9 cases, effective in 3 cases, 2 cases of poor results, 1 case ineffective. The follow-up observation time was 36 months and 20 cases, the patient survival time was 8 to 22 months, and the average survival time was 16 months. One patient was treated with hepatic artery embolization and was alive for 28 months. The total effective rate of treatment was 95.2%. Conclusion CT-guided percutaneous thermochemotherapy is an effective method for the treatment of lung and liver malignancies. It is particularly suitable for patients who cannot be surgically treated. Combining with hepatic artery embolization can improve the curative effect.