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目的探讨经肝动脉灌注利卡汀序贯联合经肝动脉化疗栓塞(TACE)治疗不可切除肝细胞癌的近期疗效与安全性。方法回顾分析接受利卡汀肝动脉灌注序贯联合常规TACE治疗的13例原发性肝癌患者资料,利卡汀肝动脉灌注剂量为27.75MBq/kg,常规TACE方案为吡柔比星和碘化油适量混合乳化行动脉化疗栓塞,并辅以适量聚乙烯醇颗粒强化栓塞。结果根据mRECIST评价标准,治疗后1个月的疾病缓解率达到69.3%,疾病控制率则为100%;3个月疾病缓解率为69.3%,疾病控制率为84.6%;6个月疾病缓解率为61.5%,疾病控制率为76.9%;9个月的疾病缓解率和疾病控制率分别为60%和80%。治疗后6个月生存率达到100%,1年、2年预测生存率分别为68%、45%。术后1个月患者肝肾功能、血象等指标同术前相比无统计学意义,所有患者均未出现严重感染、黄疸、消化道出血及骨髓抑制等并发症。结论经肝动脉灌注利卡汀序贯联合TACE治疗不可切除肝细胞癌具有较好的近期疾病缓解率、疾病控制率与良好的安全性。
Objective To investigate the short-term curative effect and safety of transcatheter arterial chemoembolization (LACEA) combined with transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC). Methods The data of 13 patients with primary hepatocellular carcinoma who received sequential intravenous injection of likacin combined with routine TACE were retrospectively analyzed. The dose of hepatic artery to Ricardine was 27.75MBq / kg. The conventional TACE regimen was pirarubicin and iodinated Oil mixed emulsion arterial chemoembolization, supplemented with appropriate amount of polyvinyl alcohol particles to strengthen the embolization. Results According to the mRECIST evaluation criteria, the disease remission rate was 69.3% and the disease control rate was 100% at 1 month after treatment. The remission rate at 3 months was 69.3% and the disease control rate was 84.6%. The remission rate at 6 months Was 61.5%, disease control rate was 76.9%; 9-month disease remission rate and disease control rate were 60% and 80%. Six months after treatment, the survival rate reached 100%. The 1-year and 2-year survival rates were 68% and 45% respectively. One month after operation, the indexes such as liver and kidney function and blood image had no statistical significance compared with those before operation. No serious infection, jaundice, gastrointestinal bleeding and myelosuppression were found in all the patients. Conclusions Intervention of hepatic artery infusion of likacin and TACE in the treatment of unresectable hepatocellular carcinoma have better recent disease remission rate, disease control rate and good safety.