关键词: 洛铂, 经肝动脉化疗栓塞术, ¹²⁵I粒子植入术, 中晚期肝癌, 前瞻性研究

Abstract: Background and purpose: Transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma is characterized by a low rate of necrosis, while ¹²⁵I seed implantation, as a new radiotherapy technique, has strong targeting advantages. In this study, we aimed to explore the clinical efficacy of ¹²⁵I seed implantation combined with TACE therapy (combined with lobaplatin as a chemotherapy drug) and 3-year survival of patients with advanced unresectable primary hepatocellular carcinoma, and to provide reference for the clinical treatment. Methods: In the prospective study, 102 patients with advanced unresectable primary hepatocellular carcinoma at the Affiliated Tumor Hospital of Zhengzhou University from January 2010 to January 2013 were selected and randomly divided into control group and observation group with 51 cases in each group. Patients in control group were treated with TACE, and the patients in observation group were treated with TACE combined with ¹²⁵I particles implantation. The changes of alpha-fetoprotein (AFP), liver function, cell immune indexes and tumor metastasis and curative effect were observed before and after 6 months of treatment. The clinical effect, 3-year survival rate and adverse reactions of the two groups were recorded and compared. Results: There was no statistically significant difference between the two groups of patients in general information and clinical related indicators before the treatment (P>0.05). After different treatment procedures, the effective rate of observation group (86.3%) was significantly higher than that of the control group (68.6%); Six months after the treatment, the serum level of AFP was significantly lower in both groups, and the serum AFP content of the observation group was significantly lower than that of the control group (P<0.05). There was no statistically significant difference in liver function indexes and cellular immune function indexes before the treatment and after the treatment for 6 months (P>0.05). The incidence of distant metastasis in the observation group was 7.8%, significantly lower than that of the control group (23.5%), survival rates of 1, 2 and 3 year were 68.6%, 43.1% and 31.4%, which were significantly higher than those of the control group (41.2%, 29.4% and 13.7%, P<0.05). Both groups had no serious complications during the follow-up period. Conclusion: The ¹²⁵I seed implantation combined with TACE therapy (combined with lobaplatin as a chemotherapy drug) is more effective in controlling tumor metastasis and improving the survival rate, which is worthy of clinical application.

Key words: Lobaplatin, Transcatheter arterial chemoembolization, ¹²⁵I seed implantation, Advanced unresectable primary hepatocellular carcinoma, Prospective study