摘要
目的评价巨大肝癌患者单纯应用经肝动脉化疗栓塞术（TACE）和综合治疗的临床疗效和预后。方法回顾性分析2008年8月至2012年1月，解放军总医院介入放射科收治的115例巨大肝癌患者，分为单纯TACE治疗组（TACE组）72例，TACE联合治疗组（综合治疗组）43例，分析其生存情况。结果115例巨大肝癌患者中，TACE组患者的中位生存时间为11个月，1、2、3年生存率分别为60．4％、23．3％和9．8％。综合治疗组患者的中位生存时间为39个月，1、2、3年生存率分别为78．1％、43．3％和36．8％，两组患者的生存曲线比较，差异有统计学意义（P〈0．001）。单因素分析结果显示，巨大肝癌患者的性别、年龄、肝炎病毒感染情况、AFP水平均与患者的预后无关（均P〉0．05），而综合治疗、Child分级、ECOG评分、远处转移情况、门脉癌栓形成和BCLC分期均与患者的预后有关（均P〈0．05）。Cox回归分析结果显示，综合治疗和ECOG评分是影响巨大肝癌患者预后的独立因素（均P〈0．05）。结论综合治疗巨大肝癌是一种安全有效的治疗策略。综合治疗及ECOG评分是影响HCC患者预后的因素。
Objective The aim of this study was to evaluate the efficacy, survival and prognosis of transarterial ehemoembolization （TACE） alone and TACE in combination with multimodality therapy for huge hepatocellular carcinoma. Methods A retrospective analysis was conducted in 115 patients with huge hepatocellular carcinoma treated in our hospital from August 2008 to January 2012. Among them, 72 patients were treated by TACE alone （TACE group） and 43 patients by TACE plus multimodality therapy （TACE combined treatment group ）. Their clinicopathological data and survival were analyzed. Results The median follow-up of the 115 eases was 24 months （range 1-40 months）. The 1-, 2-, and 3-year overall survival （OS） rates for the TACE group were 60.4, % 23.3% and 9.8%, respectively, and 39 months, 78.1%, 43.3% and 36.8%, respectively, for the combined treatment group （P 〈0.001 ）. The univariate analysis showed that the patient gender and age, HIV infection and AFP level were not significantly correlated with prognosis of the patients （P 〉 0.05 for all）, while multimodality therapy, Child＇s grading, ECOG scores, distant metastasis, and portal vein tumor thrombus were significantly related to the overall survival. Moreover, the Cox multivariate survival analysis revealed that therapy and ECOG scores were independent prognostic indicators （P 〈 0.05 for all）. Conclusions Multimodality therapy is a safe and effective treatment for huge hepatoeellular carcinoma. Multimodality therapy and ECOG scores are independent prognostic indicators for the patients.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第1期59-62,共4页
Chinese Journal of Oncology
关键词
肝肿瘤
肿瘤负荷
肝动脉化疗栓塞术
预后
射频消融
索拉非尼
Liver neoplasms
Tumor burden
Transarterial chemoembolization
prognosis
Radiofrequency ablation
Sorafenib
