目的探讨伽玛刀(γ-刀)联合高强度超声聚焦刀(HIFU)治疗小肝癌的安全性、有效性。方法 24例小肝癌先经γ-刀治疗后用HIFU治疗,观察联合治疗后近期及远期疗效,并进行生存曲线分析。结果本组病例(24例)随访时间为3~69个月(平均47.3个月),随访率100%。近期疗效:治疗3个月后,CR:5例(20.83%)、PR:14例(58.33%)、NC:3例(12.50%)、PD:2例(8.33%),治疗总有效率:79.17%(19/24)。远期疗效:随访至2014年5月,共有6例患者死亡。中位生存期为52.0个月,1、2、3年总生存率分别为86.3%、71.5%和66.4%。治疗副反应及并发症:全组患者均顺利完成治疗。治疗副反应轻微,无严重放射性肝损伤发生,患者耐受性良好。结论γ-刀联合HIFU治疗是一种安全、有效治疗小肝癌的新方法。 Objective To investigate the safety and efficacy of gamma knife (G-knife) combined with high-intensity focused ultrasound (HIFU) in the treatment of small hepatocellular carcinoma. Methods Twenty-four patients with small hepatocellular carcinoma were treated with γ-knife and treated with HIFU. The short-term and long-term therapeutic effects were observed and the survival curves were analyzed. Results The patients (24 cases) were followed up for 3 to 69 months (average 47.3 months) with a follow-up rate of 100%. Short-term efficacy: CR: 5 cases (20.83%), PR: 14 cases (58.33%), NC: 3 cases (12.50%) and PD: 79.17% (19/24). Long-term efficacy: up to May 2014, a total of 6 patients died. The median survival time was 52.0 months. The overall survival rates at 1, 2 and 3 years were 86.3%, 71.5% and 66.4%, respectively. Side effects and complications of treatment: All patients were successfully completed treatment. Minor side effects of treatment, no serious radiation-induced liver injury, patients with good tolerance. Conclusion γ-knife combined with HIFU treatment is a safe and effective treatment of small liver cancer a new method.