CAJ | 학술논문

目的：分析两种不同治疗方式在巨块型肝癌中的临床疗效及卫生经济学指标。方法纳入2008．1—2015．1在本院住院的42例巨块型肝癌，按肝动脉栓塞化疗（ TACE）术与立体定向γ刀放疗两种治疗方式进行分组，分析两组在临床疗效、不良反应与卫生经济学指标的差异。结果①γ刀治疗组的疾病控制率（ DCR）明显高于TACE组（72．7％vs 50％，P＜0．05），但二者的有效率（OR）无显著性差异（54．5％vs 35％，P＞0．05）；②γ刀治疗组的半年与1年生存率均高于TACE术组（81．8％vs 66．7％；54．5％vs 33．3％，P＝0．0467），γ刀治疗组的中位生存率（mOS）亦明显优于TACE术组；③两组的主要不良反应（恶心呕吐、转氨酶升高与发热）发生率均无统计学差异（P＞0．05）；④γ刀治疗组治疗费高于TACE组，但总住院费低于TACE术组约3700元。结论γ刀较TACE术治疗巨块型肝癌，具有更好的成果－效价比，值得推广应用。
목적：분석량충불동치료방식재거괴형간암중적림상료효급위생경제학지표。방법납입2008．1—2015．1재본원주원적42례거괴형간암，안간동맥전새화료（ TACE）술여입체정향γ도방료량충치료방식진행분조，분석량조재림상료효、불량반응여위생경제학지표적차이。결과①γ도치료조적질병공제솔（ DCR）명현고우TACE조（72．7％vs 50％，P＜0．05），단이자적유효솔（OR）무현저성차이（54．5％vs 35％，P＞0．05）；②γ도치료조적반년여1년생존솔균고우TACE술조（81．8％vs 66．7％；54．5％vs 33．3％，P＝0．0467），γ도치료조적중위생존솔（mOS）역명현우우TACE술조；③량조적주요불량반응（악심구토、전안매승고여발열）발생솔균무통계학차이（P＞0．05）；④γ도치료조치료비고우TACE조，단총주원비저우TACE술조약3700원。결론γ도교TACE술치료거괴형간암，구유경호적성과－효개비，치득추엄응용。
Objective To investigate the clinical efficacy and health economics in patients with massive hepatocellular carcinoma ( MHCC ) treated between two different treatments .Methods 42 consecutive patients with MHCC were divided into two groups , i.e.transcatheter arterial chemoembolization ( TACE) andγ-ray ster-eotactic radiotherapy (γ-knife).The clinical efficacy, side-effects, and health economics were compared in two groups .Results ①The disease control rate ( DCR ) ofγ-knife group was higher than that of TACE group (72.7%vs 50%,P<0.05),however, there was no significant difference of overall response (OR) between the two groups;②The 0 .5 , 1-year survival rate of ofγ-knife group was enhanced when compared with TACE group (81.8%vs 66.7%;54.5%vs 33.3%,P=0.0467).Also, there was higher median overall survival (mOS) inγ-knife group in comparison with TACE group (13.5m vs 8.0m, P=0.0467); ③The major side-effects were nausea and vomiting, elevation of ALT and AST, and fever.No marked difference was observed for the side -effects between the two groups .④The expense covering for treatment was higher in γ-knife treatment , but the to-tal expense forγ-knife treatment was 3700 yuans lower than that in TACE treatment .Conclusion Theγ-knife treatment may result in better effect -cost ratio in patients with MHCC , which deserves further application .