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[目的]探讨肝动脉化疗栓塞术(TACE)和经皮微波凝同术(PMCT)联合重组人血管内皮抑素(YH-16)治疗直径>5cm原发性肝细胞癌(HCC)的疗效及安全性。[方法]将所有患者随机分成3组,每组17例,分别采取不同的治疗方案,比较其疗效。A组:TACE;B组:TACE+PMCT;C组:TACE+PMCT+YH-16。[结果]1A、B、C3组客观缓解率(ORR)、疾病控制率(DCR)、中位无进展生存期(mPFS)和中位总生存期(mOS)差异均具有统计学意义(P<0.05);23组生存时间及95%置信区间、1年累计生存率和2年累计生存率差异都具有统计学意义(P<0.05);3治疗后,3组患者甲胎蛋白(AFP)降低50%的病例数所占百分比相比,差异无统计学意义(P>0.05);43组患者体力状况差异无统计学意义(P<0.05)。[结论]双介入法联合YH-16的治疗方法或可成为临床治疗肿瘤直径>5cm肝癌患者的更佳选择。
[Objective] To investigate the curative effect of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave coagulation (PMCT) combined with recombinant human endostatin (YH-16) for hepatocellular carcinoma (HCC) safety. [Methods] All patients were randomly divided into 3 groups, 17 cases in each group, and different treatment regimens were taken to compare the curative effect. Group A: TACE; Group B: TACE + PMCT; Group C: TACE + PMCT + YH-16. [Results] The objective response rates (ORR), disease control rates (DCR), median progression-free survival (mPFS) and median overall survival (mOS) in groups 1A, B and C3 were all statistically significant (P < 0.05). The 23-year survival time, 95% confidence interval, 1-year cumulative survival rate and 2-year cumulative survival rate were statistically significant (P <0.05). After 3 treatments, the AFP levels were decreased There was no significant difference between the two groups (P> 0.05). There was no significant difference in physical status between the 43 groups (P <0.05). [Conclusion] The dual interventional therapy combined with YH-16 may be a better choice for clinical treatment of patients with hepatocellular carcinoma> 5cm in diameter.