摘要
目的探讨125I粒子植入治疗原发性肝癌合并门静脉癌栓的价值。方法回顾性分析2015年1月至2018年6月间郑州大学附属肿瘤医院218例原发性肝癌合并门静脉癌栓的患者[男184例,女34例,年龄(53.8±9.2)岁]资料。对患者行CT引导下125I粒子植入术,于术后2~3个月复查CT、肝功能,比较治疗前后门静脉癌栓直径、肝功能参数及腹腔积液等并发症情况,并随访2~26个月,计算患者的生存期。应用配对t检验进行统计比较。结果125I粒子植入后2~3个月,218例患者中癌栓完全缓解8例(3.7%),部分缓解111例(50.9%),无变化80例(36.7%),疾病进展19例(8.7%),总有效率为91.3%(199/218)。治疗后癌栓直径为(12.63±4.64)mm,较治疗前减小[(26.65±10.88)mm;t=18.74,P<0.01];血清胆红素、直接胆红素分别为(20.59±10.29)、(11.40±8.37)pg/L,与治疗前[(24.27±12.65)、(15.64±7.99)pg/L]相比差异均有统计学意义(t值:5.37、8.44,均P<0.05);治疗前后血清间接胆红素差异无统计学意义(t=0.85,P>0.05)。142例有腹腔积液的患者中86例治疗后较治疗前积液情况好转。所有患者均未见与治疗相关的严重并发症。至随访结束,162例死亡,56例存活,患者总生存期(9.23±0.59)个月。结论125I粒子植入可安全、有效地治疗原发性肝癌合并门静脉癌栓,并改善腹腔积液。
Objective To investigate the clinical value of 125I seeds implantation in the treatment of primary liver cancer with portal vein tumor thrombus.Methods A total of 218 patients(184 males and 34 females,age:(53.8±9.2)years)with primary liver cancer with portal vein tumor thrombus between January 2015 and June 2018 were retrospectively analyzed.All patients underwent 125I seeds implantation under CT guidance.CT examination and liver function test were repeated 2-3 months after the implantation,and the portal vein tumor thrombus diameter,liver function parameters and ascites before and after treatment were compared.All patients were followed up for 2-26 months and the survival time were calculated.Paired t test was used for data analysis.Results Among 218 patients,8 patients(3.7%)had complete remission of tumor thrombus,111 patients(50.9%)had partial remission,80 patients(36.7%)had no change,and 19 patients(8.7%)had disease progression 2-3 months after the implantation.The total effective rate was 91.3%(199/218).The diameter of tumor thrombus after treatment was(12.63±4.64)mm,which was significantly smaller than that before treatment((26.65±10.88)mm;t=18.74,P<0.01);serum bilirubin,the direct bilirubin after treatment were different compared with those before treatment:(20.59±10.29)vs(24.27±12.65)pg/L(t=5.37,P<0.05),(11.40±8.37)vs(15.64±7.99)pg/L(t=8.44,P<0.05);the indirect bilirubin after treatment was not significantly different from that before treatment(t=0.85,P>0.05).Ascites in 86/142 patients were better after the implantation.No serious complications associated with treatment were seen.There were 162 patients died and 56 patients survived till the end of follow-up.The survival time of all patients was(9.23±0.59)months.Conclusion 125I seeds implantation can safely and effectively treat the portal vein tumor thrombus in patients with primary liver cancer,and improve the clinical symptoms such as ascites.
作者
张富强
李强
杨辉
张战胜
胡鸿涛
Zhang Fuqiang;Li Qiang;Yang Hui;Zhang Zhansheng;Hu Hongtao(Department of Nuclear Medicine,Henan Cancer Hospital,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450003,China;Department of Minimally Invasive Intervention,Henan Cancer Hospital,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2020年第3期142-146,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
