摘要
目的探讨肝动脉化疗栓塞（TACE）联合瘤栓内经皮无水乙醇注射（PEI）治疗原发性肝癌（HCC）伴门静脉主支瘤栓的临床疗效。方法回顾性分析2007年1月至2010年1月收治的51例HCC伴门静脉主支瘤栓患者资料，男性38例，女性13例，年龄24～73岁，平均50．1岁。其中采用TACE联合瘤栓内PEI治疗26例（A组），只接受TACE治疗25例（B组），两组临床资料差异无统计学意义。对比观察两组患者近期内门静脉瘤栓及肿瘤变化，随访生存时间。统计学分析应用SPSSl8．0软件包，计量资料采用两样本均数t检验，计数资料采用X2检验或FisherIs精确概率法，采用Kaplan-Meier计算中位生存期，log-rank法检验组间差异，以P〈0．05为差异有统计学意义。结果两组均未发生与治疗有关的严重并发症，51例患者随访3—24个月。A、B两组TACE治疗次数分别为（3．2±1．4）次对比（2．4土O．9）次，t=2．22，P=0．032，A组瘤栓内PEI治疗2～8次。对瘤栓有效率为19／26对比10／25，X2=5．685，P=0．019。治疗3个月及6个月时肿瘤治疗反应（CR＋PR＋SD）为20／26对比18／25，X2=0．163，P=0．705I17／20对比10／19，X2=2．58，P=0．027。生存时间：A组5～23（12．85±6．02）个月，B组4～16（8．65±3．39）个月，t=3．051，P=0．004。结论对于HCC合并门静脉主支瘤栓患者，TACE联合瘤栓内PEI治疗优于单用TACE治疗，联合治疗可以较好地控制门静脉瘤栓，增加TACE机会并延长患者生存期。
Objective To explore the therapeutic efficacy of a combined treatment modality using transcatheter arterial chemoembolization （TACE） and percutaneous ethanol injection （PEI） to treat hepatocellular carcinoma （HCC） complicated with main branch intraportal vein tumor thrombosis （PVTT）. Methods Clinical data was collected retrospectively for patients diagnosed with and treated for HCC plus main branch PVTT at our hospital between January 2007 and January 2010. The total study population （11 -- 51） consisted of 38 males and 13 females, with an average of 50.1 years （range： 24-73）. Among these patients, 26 had been treated with TACE ＋ PEI （group A） and 25 had been treated with TACE alone （group B）. Short- term changes in PVTT （i.e. disappearance, shrinkage, and/or stability） and tumor （i.e. complete response, partial response, and/or stable disease） were assessed by using the t-test （continuous variables） or the Chi-squared or Fisher＇s exact tests （categorical variables）. Between-group differences in survival time were assessed by the Kaplan-Meier analysis and log-rank test. Results The follow-up time ranged from 3-24 months after treatment, and no serious treatment-related complications were recorded for any of the patients （0/51）. The time of TACE treatment was significantly longer for the patients receiving the combination therapy （group A： 3.21.4 vs. group B： 2.40.9, t= 2.22, P =0.032）. The patients in group A received between 2-8 PEI treatments. The TACE ＋ PEIcombined treatment showed significantly better therapeutic efficacy for PVTT （group A： 19/26 vs. group B： 10/25,22 = 5.685,P = 0.019）. The tumor response was significantly better in patients treated with TACE ＋ PEI at post-treatment month 3 （group A： 20/26 vs. group B： 18/25,22 = 0.163,P = 0.705） and month 6 （group A： 17/20 vs. 10/19,22 = 2.58,P = 0.027）. Finally, the average survival time was significantly better in patients treated with TACE ＋ PEI （group A： 12.856.02 months （range： 5-23） vs. group B： 8.653.39 months （range： 4-16）, t = 3.051, P = 0.004）. Conelusion TACE ＋ PEI combination therapy for main branch PVTT in HCC patients is more efficacious than TACE alone, and is associated with a longer survival time.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2013年第5期367-371,共5页
Chinese Journal of Hepatology
关键词
癌
肝细胞
瘤栓
门静脉
化疗栓塞
乙醇
Carcinoma, hepatocellular
Tumor thrombosis, portal vein
TACE
Absolute ethonal
