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目的:研究伽玛刀联合肝动脉栓塞化疗治疗临床疗效,探索治疗原发性肝癌的最优方案。方法:选择2005年10月~2013年10月在我院伽玛刀室实施伽玛刀治疗的肝癌病例183例,随机分为对照组(n=88)和试验组(n=95),对照组患者采取单纯伽马刀治疗,试验组采用伽马刀联合肝动脉栓塞化疗。治疗后对全部患者进行随访3~24个月,复查肝功能、甲胎蛋白(AFP)等,追踪有无不良反应及并发症的出现,了解其近期与远期疗效。结果:治疗后3个月复查,对照组和试验组的总体有效率分别为60.5%和76.84%,两组近期疗效比较,差异具有统计学意义(P<0.05)。两组治疗后肝功能及AFP改善情况,差异均具有统计学意义(P<0.05)。两组患者在治疗期间及后均出现不同程度的不良反应,对照组放射诱导的肝病5例,试验组3例,经内科对症处理后,患者情况均好转。试验组在治疗后6、12、18、24个月的生存率均高于对照组,差异均存在统计学意义(P<0.05)。结论:伽玛刀联合肝动脉栓塞化疗治疗原发性肝癌的临床疗效优于单纯伽马刀治疗,可进一步研究,进行临床推广。
Objective: To study the clinical efficacy of gamma knife combined with hepatic arterial chemoembolization in the treatment of primary liver cancer. Methods: A total of 183 cases of hepatocellular carcinoma treated with Gamma Knife in our hospital from October 2005 to October 2013 were randomly divided into control group (n = 88) and experimental group (n = 95) The patients were treated with simple gamma knife, and the experimental group was treated with gamma knife combined with hepatic arterial chemoembolization. After treatment, all the patients were followed up for 3-24 months. The liver function, AFP, etc. were followed up to find out whether there were any adverse reactions or complications and to find out the short-term and long-term effects. Results: Three months after treatment, the overall effective rates of the control group and the experimental group were 60.5% and 76.84%, respectively. There was significant difference between the two groups in short-term efficacy (P <0.05). After treatment, liver function and AFP improved, the differences were statistically significant (P <0.05). Both groups showed different degrees of adverse reactions during and after treatment, 5 cases of radiation-induced liver disease in the control group and 3 cases in the experimental group. After medical symptomatic treatment, the patients’ condition improved. The survival rate of the experimental group at 6, 12, 18 and 24 months after treatment were higher than that of the control group, with statistical significance (P <0.05). Conclusion: Gamma knife combined with hepatic arterial chemoembolization in the treatment of primary liver cancer is superior to the simple gamma knife treatment, which can be further studied for clinical promotion.