摘要
目的探讨在肝癌的介入治疗中复合型栓塞剂的价值。方法将原发性肝癌患者188例分为常规组103例,复合组85例。观察并比较两组的碘油沉积、有效率、手术切除、病理改变、生存率和并发症。结果在巨块型、结节型的多血供肝癌患者中,碘油沉积表现为完全填充型和致密型。常规组和复合组碘油沉积分别为59.2%和89.4%;有效率(CR+PR)两组分别为32.0%和56.5%;手术切除率分别为5.8%和15.3%;肿瘤完全坏死率分别为1.0%和4.7%。常规组1,2,3年生存率分别为57.7%、42.8%和8.4%,复合组1,2,3年生存率分别为79.8%、55.3%和38.5%,两组比较,差异有统计学意义。并发症两组间基本相同。结论肝癌患者的介入治疗疗效与栓塞剂的用量及种类相关。对于巨块型、结节型的多血供肝癌患者,应提倡超选择复合栓塞治疗;少血供、弥漫型和不能超选择插管的肝癌患者应常规治疗。
Objective To investigate the value of transarterial chemoembolization （TACE） using mixed emboli for hepatocellular carcinoma（HCC）. Methods 188 patients with HCC were divided into two groups according to the treatment modality： 103 patients in group A treated by routine iodine embolus agent; 85 patients in group B by mixed iodine embolus agent （ ultra-liquified iodinized oil ＋ gelatin sponge ＋ chemotherapeutic agents）. The pattern of the arrested iodine deposition in the tumor,response,resectability during follow-up, pathological changes, survival and complications in the two groups were analyzed and compared. Results The pattern of full-and-dense iodine deposition in the tumor and the response rate （ CR ＋ PR） were 59.2% and 32.0% in group A, 89.4% and 56.5% in group B. Surgical resection after TACE was possible in 5.8% （6/103） of group A versus 15.3% （13/85） of group B. Complete tumor necrosis was observed in 1.0% and 4.7% in groups A and B, respectively. 1-, 2- and 3-year actual survival rates were 57.7%, 42.8% and 8.4% in group A, and 79.8%, 55.3%, 38.5% in group B. The difference in results between the two groups was statistically significant, however, the incidence of complication in the two groups was similar. Conclusion Transarterial chemoembolization with mixed iodine emboli is more effective than with the routine iodine emboli in the treatment of bulky or nodular hepatocellular carcinoma rich in blood supply. Mixed iodine emboli is tolerable without increase in severe complications.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2005年第9期557-560,共4页
Chinese Journal of Oncology
基金
国家科学技术部社会公益基金资助项目(2002DIB40092)
