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目的　探讨12 5I组织间放射治疗大肝癌和巨大肝癌的疗效。方法　选择 1999年 8月至 2 0 0 4年 3月云南省第二人民医院大肝癌和巨大肝癌病人 6 0例 ,行手术治疗 (部分巨大肝癌姑息手术 )、术中永久植入12 5I粒子行组织间内放射治疗 ;观察治疗前后病人血象、免疫指标、临床症状、脏器功能 (ALT、AST)、肿瘤标记物(AFP)、肿瘤影像学 (CT)等的变化 ;并观察 3年生存率。结果　术前、术后 1周及 3个月内血象虽有显著差异 ,但均在正常范围 ,免疫指标前后变化无统计学意义 ;治疗后病人临床症状缓解率为 95 % (5 1/ 5 4 ) ;ALT、AST由异常降至正常水平者占 80 % (32 / 4 0 )、70 % (30 / 4 3) ;AFP降低超过原数值 5 0 %者占 75 % (30 / 4 0 ) ;直径在 5～ 10cm的5 5个瘤体的治疗有效率为 76 % (4 2 / 5 5 ) ,直径 >10cm的 32个瘤体治疗有效率为 6 9% (2 2 / 32 )。结论　12 5I组织间放射治疗大肝癌方法简单、疗效显著、使用安全。

Curative effects of operation combined with brachytherapy on big hepatic carcinoma

Objective To evaluate the effect of 125 I brachytherapy in hepatic carcinoma.Methods From Aug 1999 to Mar 2004,in Second People's Hospital of Yunnan 60 patients with big hepatic carcinoma were treated with a combination of operation and permanent implantation of iodine -125 during operation.Before and after treatment,differences of blood phenomena,immunity index,clinical symptom,ALT,AST,AFP and CT were compared,and 3-year survival rate was studied.Results Before and after treatment,blood phenomena had significant difference,but all were normal. Immunity index had no significance.After treatment clinical symptom remission rate was 95%(51/54).ALT and AST were reduced to normal level in 80% of patients (32/40) and 70% of patients (30/43) respectively.AFP decreased more than 50% of originall numerical value,which was occurred in 75% of patients (30/40).The effective rate was 76%(42/55)for tumor diameter 5cm-10cm and 69%(22/32) for tumor diameter >10cm. Conclusions Treatment of big hepatic carcinoma in combination with permanent implantation iodine-125 seeds was simple,safe and effective.