摘要
目的 探讨肝动脉、门静脉双栓化疗对不能切除的原发性肝癌的治疗作用。方法 对81例不能切除的原发性肝癌进行随机分组 :双栓组 41例 ,术中植入皮下埋藏式投药泵 (CDDS) ,通过药泵经肝动脉行栓塞化疗 +门静脉局部灌注化疗 ;术后定期用同法栓塞化疗。肝动脉栓塞化疗(TACE )组 40例按Seldinger法进行 ,用药与术中肝动脉用药量相同。栓塞化疗 3次后 ,记录甲胎蛋白(AFP)、肿瘤大小、肝功能、体重、腹围及生存期 ,并进行比较。结果 栓塞化疗 3次后体重、AFP、肿瘤的缩小双栓组均明显优于TACE组 (P <0 .0 1) ,而肝功能、腹围无明显区别 (P >0 .0 5 )。双栓组与TACE组的中位生存期分别为 18.0个月及 11.1个月 ;6,9,12 ,2 4个月累积生存率分别为87.80 % ,78.0 % ,68.2 9%和 3 1.70 %及 70 .0 % ,5 2 .5 % ,3 0 .0 %和 5 .0 %。影响生存的因素主要是治疗方法、肝功能及肿瘤大小。结论 皮下埋藏式投药泵肝动脉、门静脉双插管栓塞化疗给药途径简单、方便、并发症少、疗效较TACE好 ,是治疗不能切除的肝癌的有效方法之一。
Objective To explore the therapeutic effect of dual perfusion embolization and chemotherapy via hepatic artery and portal vein(combmation treatment) in the treatment of unresectable PHC.Methods Eighty-one cases of unresectable PHC were randomly divided into two gronps: (1) Combination treatment group.Forty-one cases,These cases received embolization and chemotherapy via hepatic artery and portal vein through a drug delivery system intraoperatively,and then embolization and chemotherapy via the drug pump were given periodically. (2) TACE group.Forty cases.These cases were treated with Seldinger's technique, the dosage of drugs were the same as used in the former group during laparotomy. After 3 times of treatment, AFP, the size of tumor, liver function, body weight, abdominal perimeter, survival time of the two groups were compared.Results The weight, AFP, decrease of tumour size in combination group were much better than those in TACE group( P <0.01); but liver function, abdominal perimeter of the two groups were no significant difference( P >0.05). The median survival time in the two groups were 18.0 months and 11.1 months ( P =0.0001). The accumulating survival rate of 6, 9, 12, 24 months were 87.8%, 78.0% , 68.2%,31.7% in combination group, and 70.0%, 52.5%, 30.0%, 5.0% in TACE group, respectively . The factors affecting survival were therapeutic method, liver function, size of tumour.Conclusions Combination treatment is simple, convenient with less complications, and the effect is better than TACE. So it is an effective method for the unresectable hepatic carcinoma.
出处
《中国普通外科杂志》
CAS
CSCD
2004年第3期175-178,共4页
China Journal of General Surgery
关键词
肝肿瘤/药物疗法
栓塞
治疗性
肝动脉
门静脉
LIVER NEOPLASMS/drug ther
EMBOLIZATION,THERAPEUTIC
HEPATIC ARTERY PORTAL VAIN
