肝动脉化疗栓塞、射频消融联合<sup>125</sup>I 粒子植入序贯治疗不可切除原发性肝癌疗效观察

doi:10.3969/j.issn.1671-7171.2016.12.006

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Abstract 【Objective】To discuss the clinical efficacy of the combined treatment of transcatheter aiterial chemoembolization (TACE), CT-guided radiofrequency ablation (RFA) and radioactive ¹²⁵I particle implantation for unresectable hepatocellular carcinoma (HCC).【Methods】Twenty patients with HCC were collected from March 2014 to February 2016 (a total of 32 cancer foci, 3~12 cm). All cancers were inicially treated with TACE, 1 week later with RFA guided by CT, and with ¹²⁵I particle implantation under CT guidance another week later. ¹²⁵I particle implantation was performed by preoperative TPS and intraoperative CT guided coaxial method, The prescription dose (PD) of particle implantation was 80~100 Gy, CT detection was transferred into TPS immediately after operation to verify the quality of particle implantation. The changes of clinical symptoms, alpha fetoprotein (AFP), liver function, imaging (tumor volume) and the clinical efficacy, tumor recurrence and related complications were observed through follow-up.【Results】20 patients were significantly relieved after treatment, AFP was significantly decreased compared with the conditions before treatment, the difference was statistically significant(P<0.05);ALT, TBIL and ALB were all decreased, but there was no significant difference (P>0.05); The imaging examination showed that the tumor necrosis, iodized oil deposition at different degree and the tumor volume were significantly reduced compared with those before treatment (P<0.05), and there was no obvious enhancement after enhancement; the immediate TPS verification after ¹²⁵I particle implantation showed that the technical success rate was 100%, that was, the quality of particle implantation was very good, D90 > MPD, CI=1 in 1 case, the dose inhomogeneity of implanted particles was 20%PD. The follow-up time was 3~ 24 months (mean, 12.7 months), the complete necrosis rate of the whole group was 93.75% (30/32), the median survival time was 11.2 months, and the half year and the 1 year survival rates were 95% and 75%, respectively. No serious complications occurred.【Conclusion】The recent curative effect of TACE, RFA combined with ¹²⁵I particle implantation in the treatment of unresectable HCC is obvious, and it is expected to be a more effective therapy model for HCC.

Key words： Hepatic Artery Chemoembolization, Therapeutic Catheter Ablation Iodine Radioisotopes/TU Liver Neoplasms/TH

Received: 22 June 2016

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R735.7

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2016.12.006 OR http://www.jcr.net.cn/EN/Y2016/V33/I12/2304

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