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目的 :探讨肝动脉灌注化疗联合无水乙醇注射治疗不能切除的原发性肝癌的临床疗效。方法 :4 1例经病理证实的不能切除的中晚期原发性肝癌病人 ,分为 3组进行治疗 :经皮下埋植式药泵经肝动脉插管灌注化疗组 (HAI组 ,14例 ) ;无水乙醇注射治疗组 (ITIE组 ,15例 ) ;经皮下埋植式药泵经肝动脉插管灌注化疗联合无水乙醇注射治疗组 (联合治疗组 ,12例 )。结果 :治疗后获二期手术切除率 ,三组分别为 7.1%、6 .6 %、2 5 % (P<0 .0 1) ;治疗后 0 .5、1、2年生存率HAI组为 5 7.1%、4 2 .8%、2 1.4 % ;ITIE组为 6 0 %、4 0 %、2 0 % ;联合治疗组为 83.3%、6 6 .6 %、33.3%。HAI组与ITIE组间生存无显著性差异 ,但联合治疗组与HAI或ITIE组间 0 .5、1、2年生存率均有显著性差异 (P <0 .0 1)。结论 :HAI +ITIE联合疗法是治疗不能切除的原发性肝癌的有效方法 ,效果优于单纯肝动脉灌注化疗和单纯无水乙醇注射治疗。
Objective: To investigate the clinical efficacy of hepatic arterial infusion chemotherapy combined with absolute ethanol injection in the treatment of unresectable primary liver cancer. Methods: A total of 41 patients with unresectable primary liver cancer who had been proved by pathology were divided into three groups: transcatheter arterial infusion chemotherapy (HAI group, 14 cases) by subcutaneous implantable drug pump; (ITIE group, n = 15). The transplanted drug pump was transcatheter hepatic arterial infusion chemotherapy combined with ethanol injection therapy group (combination therapy group, 12 cases). Results: After the operation, the resection rate of the second phase was 7.1%, 6.6%, 25% (P <0.01) in the three groups, respectively. The 0.5, 1, 5 7.1%, 42.8%, and 21.4% respectively. The ITIE group was 60%, 40% and 20%. The combined treatment group was 83.3%, 66.6% and 33.3%, respectively. There was no significant difference in survival between HAI group and ITIE group, but there was significant difference between 0. 5, 1, 2-year survival rate in combination therapy group and HAI or ITIE group (P <0.01). Conclusion: HAI + ITIE combination therapy is an effective method for the treatment of unresectable primary liver cancer, which is superior to hepatic arterial infusion chemotherapy and pure ethanol injection.