CT下射频消融术联合靶向疗法治疗肾癌的临床效果

2020-08-31 11:32:23 中国当代医药 2020年20期

荆昉宇 胡欣

[摘要] 目的 探討CT下射频消融术联合靶向疗法治疗肾癌的临床效果。方法 选取2018年2月~2019年4月本溪市中心医院收治的79例肾癌患者作为研究对象,依据盲抽法随机分为对照组(n=39)与观察组(n=40)。对照组采用靶向疗法治疗,观察组采用CT下射频消融术+靶向疗法治疗,比较两组患者的临床疗效、肿瘤标志物水平。结果 观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组患者治疗前的癌胚抗原(CEA)、糖类抗原125(CA125)水平比较,差异无统计学意义(P>0.05);两组患者治疗后的CEA、CA125水平均低于治疗前,观察组患者治疗后的CEA、CA125水平低于对照组,差异有统计学意义(P<0.05)。结论 肾癌应用CT下射频消融术结合靶向疗法治疗效果显著,可有效降低肿瘤标志物水平。

[关键词]肾癌;CT下射频消融术;靶向疗法;肿瘤标志物水平

[中图分类号] R737.11          [文献标识码] A          [文章编号] 1674-4721(2020)7(b)-0113-03

Clinical effect of radiofrequency ablation combined with targeted therapy under CT on renal cancer

JING Fang-yu   HU Xin

1. Department of Internal Medicine,Benxi Central Hospital, Liaoning Province, Benxi   117000, China; 2. Department of Internal Medicine, Liaoning Health Industry Group Bengang General Hospital, Liaoning Province, Benxi   117000, China

[Abstract] Objective To explore the clinical effect of radiofrequency ablation combined with targeted therapy under CT on renal cancer. Methods A total of 79 patients with renal cancer treated in Benxi Central Hospital from February 2018 to April 2019 were selected as the research objects, and randomly divided into the control group (n=39) and the observation group (n=40) according to the double-blind method. The control group was treated with targeted therapy, and the observation group was treated with radiofrequency ablation + targeted therapy under CT. The clinical efficacy and tumor marker levels of the two groups were compared. Results The total effective rate of treatment in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). There were no significant differences between the two groups in the levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) before treatment (P>0.05); the levels of CEA and CA125 after treatment in the two groups were lower than those before treatment, and the levels of CEA and CA125 in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusions Radiofrequency ablation combined with targeted therapy for renal cancer using CT has significant curative effect and can effectively reduce tumor marker levels.

[Key words] Renal cancer; Radiofrequency ablation under CT; Targeted therapy; Tumor marker levels

近年来靶向药物被临床广泛用于肾癌治疗中,吉非替尼是最常用的靶向药物,其为表皮生长因子受体抑制剂,可选择性抑制酪氨酸激酶活性,阻止肿瘤组织生长及转移,促进肿瘤细胞凋亡,将其与常规化疗方案联合使用,可提高治疗效果,扼制疾病发展[8-9]。但经临床研究发现,靶向药物与化疗药物联合使用仍难达到满意治疗效果,故临床仍需探索肾癌治疗新方案。射频消融术属于肾癌新型治疗手段,其主要是利用电极波杀灭肿瘤细胞,电极针于肿瘤组织内部可利用射频电流促使肿瘤细胞产生量热,高温导致肿瘤组织内蛋白质变性,进而促进肿瘤组织DNA断裂、坏死,起到杀灭肿瘤组织的目的,进而提高临床治疗效果[10-12]。同时,高温可促进肾脏周围血管凝固,防止肿瘤组织转移,且因肾脏周围正常组织内部具有大量气体,故其导热、导电性较大,再利于射频电极聚集,促使肿瘤组织彻底坏死,有效降低CEA、CA125水平[13-15]。采用CT引导利于观察肿瘤组织,并进行有效穿刺,可避免损伤其他正常器官,安全性更高。将两者联合使用,可利用其不同机制发挥杀灭肿瘤细胞的作用,进而提高临床治疗效果,使肿瘤标志物水平大幅下降。本研究结果显示,治疗后观察组患者的总有效率高于对照组,CEA、CA125水平低于对照组,差异有统计学意义(P<0.05),提示将CT下射频消融术与靶向疗法结合应用可提高临床疗效,降低肿瘤标志物水平。但经临床实践发现,CT下射频消融术对病灶直径具有一定要求,若病灶直径较大,则需进行多次重叠治疗,且重叠治疗难度较大,操作步骤较为复杂,故选取治疗方式前需明确肿瘤直径大小,以保障治疗效果[16]。本研究虽证实了CT下射频消融术联合靶向疗法治疗效果较佳,但尚未探讨其联合应用的远期疗效,且研究入选样本量较少,故研究结果存有局限,因此临床仍需加大样本量深入研究,进一步证实两者联合使用的治疗效果,并探讨其远期疗效。

综上所述,应用CT下射频消融术结合靶向疗法治疗肾癌疗效显著,可有效降低肿瘤标志物水平,值得临床推广应用。

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(收稿日期:2019-12-12)