摘要
目的 探讨大肝癌经肝动脉门静脉化学药物栓塞治疗 (TACE +PVCE)缩小后 ,再行 2期外科综合性治疗的治疗效果。方法 对大肝癌 48例行TACE +PVCE治疗。癌灶明显缩小后 ,15例行肝癌切除术 ;在B型超声引导下经皮经肝穿刺 ,2 3例行癌灶内无水酒精注射 ,10例行癌灶深度冷冻。结果 TACE +PVCE治疗后 ,肝癌癌灶由平均直径 10 6cm缩小到 4 6cm ;AFP阳性 2 7例中 ,降至正常 19例 ;在切除的肝癌标本 15例中 ,癌灶已完全坏死 9例 ,癌灶坏死范围超过 6 0 %者 6例。 2期外科综合治疗后的 1、3、5年生存率分别为 86 % ,6 8%和 5 7%。其中手术切除组 5年生存率 6 2 % ,略高于无水酒精注射 (5 5 % )和深度冷冻组 (47% ) (P <0 0 5 )。结论 TACE +PVCE可使大肝癌缩小 ,并为 2期外科综合治疗提供机会 ,根据肝癌及患者的具体情况 ,选用相应的 2期治疗方法 ,可获较满意的疗效。
Objective [WT5”BZ]To study the effects of secondary liver resection after transcatheter hepatic arterial chemoembolization (TACE) and transportal venous chemoembolization (PVCE) for huge primary hepatic carcinoma.[WT5”HZ]Methods [WT5”BZ]TACE and PVCE were used in 48 patients with huge hepatic carcinoma in which the tumor size averaged larger than 10 cm.15 patients underwent secondary tumor resection Ultrasound guided precutanous ethanol injection therapy (PEIT) was used in 23 patients, 10 patients treated by cryosurgery.[WT5”HZ]Results [WT5”BZ]The mean diameter of the liver twmors shrunk from 10 6cm to 4 6cm.The αFP level returned to normal in 19 out of 27 cases after TACE and PVCE. 15 reseted tumor samples were examinated by pathology.It was showed that tumor was in complete necrosis in 9 cases.All of the patients were followed up, it was found that 1 ,3 and 5 year survival rates were 85 6%、68 4% and 56 6% respectively. The 5 year survival rate of tumor resection group was 62 5%, compared to the group of PEIT (55 3%) and of cryosurgery (47 2%) ( P <0 05).[WT5”HZ]Conclusions [WT5”BZ]TACE and PVCE by inducing tumor necrosis made secondary resection possible in those patients with primarily unresetable large hepatic carinoma,and prolonged the patients survival.
出处
《中华普通外科杂志》
CSCD
2000年第1期10-11,共2页
Chinese Journal of General Surgery
关键词
肝细胞癌
综合疗法
栓塞疗法
外科手术
Carcinoma, hepatocellular
Embolization,therapeutic
Combined modality therapy
