聚合白蛋白和~(32)P胶体内照射治疗肝癌的疗效观察

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目的 探讨聚合白蛋白 (MAA)和32 P胶体内照射治疗肝癌的疗效和副作用。方法  2 6例肝癌患者接受B超引导下瘤内注射MAA和32 P胶体治疗 ,观察治疗前后患者的临床表现、肿物大小、甲胎球蛋白 (AFP)水平、组织病理学以及肝肾功能、血常规和免疫指标。结果 治疗后临床症状减轻 ,AFP水平下降 ;组织学示治疗区肿瘤组织完全或部分坏死、纤维化。完全缓解 (CR) 2例 ,部分缓解 (PR) 13例 ,好转 (MR) 2例 ,稳定 (SD) 7例 ,进展 (PD) 2例 ,总有效率为 5 7.7%。 5例治疗后行二期手术。 1、2、3年生存率分别为 88.5 %、76 .9%、38.5 % ,中位生存期 16个月。局部无并发症 ,治疗前后肝肾功能、血常规和免疫指标无变化。结论 MAA和胶体32 P内照射治疗肝癌是一种简单、安全和有效的新方法 ,副作用小、适应证广 Objective To investigate the therapeutic effect and side effects of polymerized albumin (MAA) and 32 P colloidal irradiation for liver cancer. Methods Twenty-six patients with hepatocellular carcinoma underwent intratumoral injection of MAA and 32 P colloids under the guidance of B-ultrasound. The clinical manifestations, tumor size, AFP levels, histopathology, and liver and kidney function were observed before and after treatment. Blood routine and immune indicators. Results After treatment, the clinical symptoms were relieved and the AFP level was decreased. The histology showed that the tumor tissue in the treatment area was completely or partially necrotic and fibrosis. There were 2 cases of complete remission (CR), 13 cases of partial remission (PR), 2 cases of improvement (MR), 7 cases of stable (SD), and 2 cases of progressive (PD). The total effective rate was 5 7.7%. Five patients underwent secondary surgery after treatment. The 1-, 2-, and 3-year survival rates were 88.5 %, 76.9%, and 38.5%, respectively, with a median survival of 16 months. No local complications, no changes in liver and kidney function, blood routine and immune parameters before and after treatment. Conclusions MAA and colloidal 32 P radiation therapy for liver cancer is a simple, safe and effective new method with small side effects and wide indications.
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