摘要
目的 探讨评价精细肝动脉栓塞化疗术(TACE)联合射波刀治疗不可切除肝恶性肿瘤的安全性和有效性.方法 选取晚期不可切除肝恶性肿瘤患者 46 例,将其分为对照组(31 例)和联合组(15 例).对照组采用单纯TACE方案或单纯射波刀方案,联合组采用精细TACE+射波刀治疗方案,TACE术中均采用微导管超选择后锥形束CT验证后栓塞.观察无进展生存时间(PFS)、总生存期(OS)、不良反应(CTCAE 5.0)、白蛋白-胆红素评分(ALBI)、D-2 聚体及卡氏评分(KPS).结果 联合组 PFS 为 10.13(2.0,27.0)个月,高于对照组的 4.70(1.0,18.0)个月,差异有统计学意义(f=8.131,P=0.010).联合组客观缓解率(ORR)和疾病控制率(DCR)分别为 47.7%和 86.7%,均高于对照组的38.7%和 74.2%,差异无统计学意义(P=0.500).整体中Ⅰ、Ⅱ和Ⅲ级不良反应发生比例分别为 13.7%、5.8%、2.4%.对照组与联合组的AFP、ALBI、D-2 等相关指标比较,差异均无统计学意义(P>0.05).结论 精细TACE+射波刀治疗对不可切除肝恶性肿瘤的疗效优于单纯TACE或单纯射波刀治疗,且安全性较好.
Abstract
Objective To evaluate the safety and efficacy of fine TACE combined with the cyberknife in the treatment of unre-sectable liver malignant tumors.Methods Forty-six patients with advanced unresectable hepatic malignancies were divided into control group(31 cases)and combination group(15 cases).The patients in control group were treated with TACE alone or-with cyberknife alone,while,patients in the combined treatment group were treated with TACE+cyberknife.During TACE sur-gery,embolization was performed after microcatheter superselection and conical beam CT verification.Progression-free survival(PFS),overall survival(OS),adverse reactions(CTCAE5.0),albumin-bilirubin score(ALBI),D-2 polymers and quality of life(KPS)scores were observed.Results The PFS of the combined group was 10.13(2.0,27.0)months,higher than 4.70(1.0,18.0)months of the control group,and the difference was statistically significant(f=8.131,P=0.010).The ORR and DCR of the combined group were 47.7%and 86.7%,respectively,higher than 38.7%and 74.2%of the control group,but the differ-ence was not statistically significant(P=0.500).The proportion of grade Ⅰ、Ⅱ and Ⅲ adverse reactions was 13.7%、5.8%and 2.4%,respectively.There was no significant difference in AFP,ALBI,D-2 and other related indexes between control group and combination group(P>0.05).Conclusion The efficacy of the combination group(TACE+cyberknife)in the treatment of unre-sectable hepatic malignancies is better than that of the reference group with TACE or cyberknife alone,and the safety is better.
基金项目
山东省潍坊市卫生健康委科研项目(WFWSJK-2021-185)
NETL
NSTL
万方数据