CAJ | 학술논문

目的：分析射频消融（RFA）联合131I肿瘤细胞核人鼠嵌合单克隆抗体131I- chTNT治疗中晚期肝癌的安全性和疗效。方法回顾性分析34例原发性肝癌患者的临床资料，分为射频消融组22例，射频消融+131I- chTNT注射组（联合组）12例，随访时间5～48个月，评价其生存期和安全指标，包括肝损伤、骨髓毒性及甲状腺损伤等。结果联合组术后7d复查血红细胞、血小板未见明显下降，血白细胞指数略升高，具有统计学意义。术后7dALT、AST明显升高，TBIL轻微升高。与术前相比，ALT、AST的差异有统计学意义，TBIL的差异无统计学意义。治疗后1个月查甲状腺功能，T3、T4、TSH、FT3、FT4与术前比较无明显变化。联合组治疗术后1个月复查增强CT或增强MRI，其中CR2例，PR8例，SD1例，PD1例。联合组中位总生存期较单纯射频治疗组有延长的趋势（P=0.052）。结论对于中晚期肝癌，射频消融联合131I- chTNT瘤内注射治疗中晚期肝癌是安全有效，未对肝功能、骨髓、甲状腺功能等产生不良影响。但尚需大样本研究其不良反应。
목적：분석사빈소융（RFA）연합131I종류세포핵인서감합단극륭항체131I- chTNT치료중만기간암적안전성화료효。방법회고성분석34례원발성간암환자적림상자료，분위사빈소융조22례，사빈소융+131I- chTNT주사조（연합조）12례，수방시간5～48개월，평개기생존기화안전지표，포괄간손상、골수독성급갑상선손상등。결과연합조술후7d복사혈홍세포、혈소판미견명현하강，혈백세포지수략승고，구유통계학의의。술후7dALT、AST명현승고，TBIL경미승고。여술전상비，ALT、AST적차이유통계학의의，TBIL적차이무통계학의의。치료후1개월사갑상선공능，T3、T4、TSH、FT3、FT4여술전비교무명현변화。연합조치료술후1개월복사증강CT혹증강MRI，기중CR2례，PR8례，SD1례，PD1례。연합조중위총생존기교단순사빈치료조유연장적추세（P=0.052）。결론대우중만기간암，사빈소융연합131I- chTNT류내주사치료중만기간암시안전유효，미대간공능、골수、갑상선공능등산생불량영향。단상수대양본연구기불량반응。
Objective To evaluate the efficacy and safety of 131I- chTNT combined with radiofrequency ablation in treatment of advanced hepatocel ular carcinoma. Methods Thirty four patients with hepatocel ular carcinoma were treated with radiofrequency ablation (RFA group, n=22) or radiofrequency ablation combined with 131I- chTNT(combination group, n=12 cases) and fol owed up 5~48 months, the clinical data were retrospectively analyzed. The survival and safety indicators (including liver damage, bone marrow toxicity and thyroid lesions)were analyzed and compared between two groups, Results In combination group the red blood cel s, platelets were not declined, leucocytes was significantly elevated which has statistical significance and ALT and AST increased significantly, TBIL was not changed at d7 after operation, compared with those preoperatively. There were no significant changes in thyroid function, T3, T4, TSH, FT3 and FT4 1 month after treatment compared with those preoperatively. The contrast enhanced CT or MRI results showed there were 2 cases of CR, 8 cases of PR, 1 case of SD and1 case of PD at 1 month after treatment. There was an increasing tendency of median overal survival incombination group than that in RFA group (P=0.052). Conclusion For advanced hepatocel ular carcinoma, RFA combined with vivatuxin treatment is safe and ef-fective, but it stil need large sample study to confirm.