125I粒子植入或3DCRT联合TACE治疗晚期原发性肝癌患者临床疗效对比研究*

doi:10.3969/j.issn.1672-5069.2020.02.030

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (2): 268-271.doi: 10.3969/j.issn.1672-5069.2020.02.030

¹²⁵I粒子植入或3DCRT联合TACE治疗晚期原发性肝癌患者临床疗效对比研究^*

胡鸿, 廖运国, 魏欣, 唐梓瑜, 邓丹, 蒲嘉骐, 钟立明

637000 四川省南充市川北医学院第二临床医学院/南充市中心医院介入放射科

收稿日期:2019-06-25 出版日期:2020-03-10 发布日期:2020-04-20
通讯作者: 钟立明,E-mail:625826874@qq.com
作者简介:胡鸿,男,47岁,大学本科,副主任医师。研究方向:影像学诊断与介入治疗
基金资助:
南充市科学技术和知识产权局科研基金资助项目(编号:KY-16YFZJ0023)

Clinical comparison of ¹²⁵I seed implantation or 3DCRT and TACE combination in treatment of patients with advanced hepatocellular carcinoma

Hu Hong, Liao Yunguo, Wei Xin, et al

Department of Interventional Radiology, Second Clinical Medical School, Northern Sichuan Medical College, Nanchong 637000,Sichuang Province, China

Received:2019-06-25 Online:2020-03-10 Published:2020-04-20

摘要/Abstract

摘要： 目的研究¹²⁵I粒子植入或者三维适形放射治疗(3DCRT)联合肝动脉化疗栓塞(TACE)治疗肝细胞癌(HCC)患者的临床疗效。方法采用随机数字表法将92例HCC患者分为观察组和对照组,每组46例。在观察组,采用¹²⁵I粒子植入联合TACE治疗,对照组患者接受3DCRT联合TACE治疗。检测血清甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)和高尔基体蛋白73(GP73)。结果治疗后第4周时,观察组和对照组疾病控制率分别为62.5%和57.5%(P>0.05)],观察组和对照组1 a生存率分别为52.5%和45.0%(P>0.05)];治疗前和治疗后1月,两组血清AFP、AFP-L3和GP73水平比较,差异均无统计学意义(P>0.05);在治疗期间,两组白细胞降低、贫血、血小板降低和胃肠道反应发生率比较,差异均无统计学意义(P>0.05),观察组放射性肝损伤严重程度较对照组显著减轻,差异有统计学意义(P<0.05)。结论采用TACE治疗晚期肝癌患者短期有效,与¹²⁵I粒子植入或3DCRT联合治疗可提高疗效,但联合¹²⁵I粒子植入可能副反应更轻。

关键词: 肝细胞癌, 肝动脉化疗栓塞, ¹²⁵I粒子植入, 三维适形放疗, 疗效

Abstract: Objective The purpose of this study was to observe the clinicalefficacy of ¹²⁵I seed implantation or 3-dimensional conformal radiation therapy (3DCRT) and transcatheter artery chemoembolization(TACE) combination intreatment of patients with advanced hepatocellular carcinoma (HCC). Methods 92 patients with advanced HCC were recruited and were randomly divided intoobservation and control group, with 46 cases in each group. The patients inobservation group were treated with¹²⁵I seed implantation and TACE combination,and those in the control group were treated with 3D CRT combined with TACE.The short-term efficacy was evaluated and adverse reactions were recorded.Serum alpha-fetoprotein (AFP), alpha-fetoprotein heterogenous L3(AFP-L3) andGolgi protein (GP73) were detected. Results The disease control rates at 4thweek after treatment in the observation and the control group were 62.5% and57.5%(P>0.05), and the 1-year survival rates in the two groups were 52.5%and 45.0% (P > 0.05); at presentation and one month after treatment, there werenosignificant differences as comparison of serum AFP, AFP-L3 and GP73 levels in thetwo groups (P>0.05); the incidences of leucopenia, anemia, thrombocytopenia,and gut reaction during the treatment in the two groups were notsignificantlydifferent (P>0.05), while the incidence of radiation-induced liver injury inthe observation group was much lower than that in the control (P<0.05). Conclusion The short-term efficacy of ¹²⁵I seed implantation combined with TACE in the treatment of patients with advanced HCC is similar to that of 3D CRT combined with TACE, while the former is safer a mild side effects occur.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization, ¹²⁵I seed implantation, Three-dimensional suitable radiotherapy, Efficacy

胡鸿, 廖运国, 魏欣, 唐梓瑜, 邓丹, 蒲嘉骐, 钟立明. ¹²⁵I粒子植入或3DCRT联合TACE治疗晚期原发性肝癌患者临床疗效对比研究^*[J]. 实用肝脏病杂志, 2020, 23(2): 268-271.

Hu Hong, Liao Yunguo, Wei Xin, et al. Clinical comparison of ¹²⁵I seed implantation or 3DCRT and TACE combination in treatment of patients with advanced hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2020, 23(2): 268-271.

参考文献

[1] Kim B H, Park J W. Epidemiology of liver cancer in South Korea.Clin Mol Hepatol, 2017,24(1):1-9.
[2] Ho M C, Hasegawa K, Chen X P, et al. Surgery for intermediate and advanced hepatocellular carcinoma: A consensus report from the 5th Asia-pacific primary liver cancer expert meeting (APPLE 2014). Liver Cancer, 2016, 5(4):245-256.
[3] 张伟,陈刚,孙密密,等.经导管肝动脉化疗栓塞联合射频消融治疗原发性PLC患者临床疗效评价.实用肝脏病杂志,2017,20(4):472-476.
[4] Shiraishi S, Moore K L. Knowledge-based prediction of three-dimensional dose distributions for external beam radiotherapy.Med Phys,2016,43(1):378-387.
[5] Rades D, Bolm L, Schild S E, et al. Survival following palliative external-beam radiotherapy of locally advanced and metastatic liver cancer.Anticancer Res, 2017,37(1):203-210.
[6] 中国抗癌协会PLC专业委员会,中国抗癌协会临床肿瘤学协作专业委员会,中华医学会肝病学分会原发性肝癌学组.原发性肝癌规范化诊治的专家共识.中华肝脏病杂志,2009,17(6):403-410.
[7] 王巍伟,孙家耀,王征,等.质子重离子治疗靠近消化道肝癌的剂量学研究.中华放射肿瘤学杂志,2018,27(11):999-1003.
[8] Nishino M, Jackman D H, Yeap B Y, et al. New response evaluation criteria in solid tumors (RECIST) guidelines for advanced non-small cell lung cancer:comparison with original RECIST and impact on assessment of tumor response to targeted therapy. Am J Roentgenol, 2010,195(3):221-228.
[9] Hu B, Yang X R, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma.Clin Cancer Res, 2014,20(23):6212-6222.
[10] Guha C, Kavanagh BD. Hepatic radiation toxicity: avoidance and amelioration.Semin Radiat Oncol,2011,21(4):256-263.
[11] Lyu N , Kong Y , Mu L ,et al. Effect of perioperative parecoxib sodium on postoperative pain control for transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma: a prospective randomized trial.Eur Radiol,2016,26(10):3492-3499.
[12] Lee T Y , Lin C C , Chen C Y , et al. Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early–intermediate stage hepatocellular carcinoma: A post hoc analysis of the START trial.Medicine,2017,96(37):e7655-e7658.
[13] Lee M W , Park S G , Woo H Y , et al. Three-dimensional conformal radiotherapy for portal vein tumor thrombosis in advanced hepatocellular carcinoma.Gastroenterology,2017,152(5):S1175-S1176.
[14] Colbert L E, Moningi S, Chadha A, et al. Dose escalation with an IMRT technique in 15 to 28 fractions is better tolerated than standard doses of 3DCRT for LAPC.Adv Radiat Oncol, 2017,2(3):403-415.
[15] Zhao J, Hu W, Cai G, et al. Dosimetric comparisons of VMAT, IMRT and 3DCRT for locally advanced rectal cancer with simultaneous integrated boost.Med Phys, 2016,7(5):6345-6351.
[16] Van Roozendaal L M , Schipper R J , Smit L H M , et al. Three-dimensional breast radiotherapy and the elective radiation dose at the sentinel lymph node site in breast cancer.Ann Surg Oncol,2015,22(12):3824-3830.
[17] Xiong J , Chian S K , Li J , et al. Iodine-125 seed implantation for synchronous pancreatic metastases from hepatocellular carcinoma: A case report and literature review.Medicine,2017,96(46):e8726-e8731.
[18] 牛焕章,肖全平,李东民,等.¹²⁵I粒子植入联合肝动脉化疗栓塞治疗中晚期原发性肝癌的近期疗效.中华肝胆外科杂志,2017,23(11):776-781.
[19] Zhang J, Wu N, Lian Z, et al. The combined antitumor effects of¹²⁵I radioactive particle implantation and cytokine-induced killer cell therapy on xenograft hepatocellular carcinoma in a mouse model.Technol Cancer Res T,2017,16(6):1083-1091.
[20] Yao M , Wang L , Leung P S C , et al. The clinical significance of GP73 in immunologically mediated chronic liver diseases: experimental data and literature review.Clin Rev Allerg Immu, 2018,54(2):282-294.

¹²⁵I粒子植入或3DCRT联合TACE治疗晚期原发性肝癌患者临床疗效对比研究^*

Clinical comparison of ¹²⁵I seed implantation or 3DCRT and TACE combination in treatment of patients with advanced hepatocellular carcinoma

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