TACE聯(lián)合微波消融及侖伐替尼治療中晚期肝癌的效果觀察

【摘要】 目的：觀察肝動(dòng)脈化療栓塞（TACE）聯(lián)合微波消融及侖伐替尼治療中晚期肝癌的效果。方法：選取江西省腫瘤醫(yī)院2020年5月—2021年5月收治的80例中晚期肝癌患者，依隨機(jī)數(shù)字表法分為對(duì)照組、試驗(yàn)組，每組40例。對(duì)照組接受TACE聯(lián)合微波消融治療，試驗(yàn)組接受TACE聯(lián)合微波消融及侖伐替尼治療；對(duì)比兩組臨床療效、腫瘤標(biāo)志物[癌胚抗原（CEA）、甲胎蛋白（AFP）]水平、肝功能指標(biāo)[谷丙轉(zhuǎn)氨酶（ALT）、谷草轉(zhuǎn)氨酶（AST）]及12個(gè)月生存率。結(jié)果：治療結(jié)束6個(gè)月時(shí)，試驗(yàn)組客觀緩解率、疾病控制率均較對(duì)照組高，差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；試驗(yàn)組治療1個(gè)月CEA、AFP、ALT、AST水平均較對(duì)照組低，差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）；試驗(yàn)組12個(gè)月生存率較對(duì)照組高，差異均有統(tǒng)計(jì)學(xué)意義（Plt;0.05）。結(jié)論：中晚期肝癌患者采用TACE聯(lián)合微波消融及侖伐替尼治療效果較好，可降低腫瘤標(biāo)志物水平，提高肝功能，改善預(yù)后。

【關(guān)鍵詞】 中晚期肝癌 肝動(dòng)脈化療栓塞 微波消融 侖伐替尼 腫瘤標(biāo)志物 生存期

Effect Observation of TACE Combined with Microwave Ablation and Lenvatinib in the Treatment of Middle and Advanced Liver Cancer/HE Jun， XIE Changji， ZHOU Xinwen. //Medical Innovation of China， 2023， 20（31）： 0-027

[Abstract] Objective： To observe the efficacy of transcatheter arterial chemoembolization （TACE） combined with microwave ablation and Lenvatinib in the treatment of middle and advanced liver cancer. Method： A total of 80 patients with middle and advanced liver cancer admitted to Jiangxi Cancer Hospital from May 2020 to May 2021 were selected and divided into the control group and the experimental group according to random number table method， with 40 cases in each group. The control group received TACE combined with microwave ablation， and the experimental group received TACE combined with microwave ablation and Lenvatinib. Clinical efficacy， tumor marker [carcinoembryonic antigen （CEA）， alpha-fetoprotein （AFP）] levels， liver function indexes [alanine transaminase （ALT）， aspartate transaminase （AST）] and 12-month survival rate were compared between the two groups. Result： At 6 months after the end of treatment， the objective remission rate and disease control rate of the experimental group were higher than those of the control group， the differences were statistically significant （Plt;0.05）. The levels of CEA， AFP， ALT and AST in the experimental group were lower than those in the control group after 1 month of treatment， the differences were statistically significant （Plt;0.05）. The 12-month survival rate of the experimental group was higher than that of control group， the difference was statistically significant （Plt;0.05）. Conclusion： TACE combined with microwave ablation and Lenvatinib can reduce the level of tumor markers， improve liver function and improve prognosis in patients with middle and advanced liver cancer.

[Key words] Middle and advanced liver cancer Transcatheter arterial chemoembolization Microwave ablation Lenvatinib Tumor marker Survival period

First-author's address： Jiangxi Cancer Hospital， Nanchang 330029， China

doi：10.3969/j.issn.1674-4985.2023.31.006

肝癌作為常見惡性腫瘤之一，其病因涉及飲酒、肝炎、遺傳等多方面，具有較高發(fā)病率，且報(bào)道顯示，該病病死率位居全部惡性腫瘤第2位[1]。手術(shù)作為肝癌有效治療方案，可完整切除病灶，遏制疾病進(jìn)展，但該病缺乏典型癥狀，大部分患者就診時(shí)病情已進(jìn)展至中晚期，錯(cuò)失最佳治療時(shí)機(jī)[2-3]。目前，臨床多采用肝動(dòng)脈化療栓塞（TACE）治療中晚期肝癌，其通過栓塞病灶主要供血?jiǎng)用}，加之利用化療藥物細(xì)胞毒性，可促進(jìn)腫瘤細(xì)胞凋亡[4]。微波消融為新型消融技術(shù)，其利用電磁波生成的熱能，可直接損害腫瘤細(xì)胞，遏制病灶生長(zhǎng)[5]。……