化学栓塞-冷消融-酒精注射序贯治疗不能手术切除的肝细胞癌  

Sequential therapy consisted of transarterial chemoembolization-cryoablation-percutaneous ethanol injection for unresectable hepatocellular carcinoma

作　　者：徐克成[1] 牛立志[1] 周强[1] 何卫兵[1] 郭子倩[1] 左建生[1] 

机构地区：[1]广州复大肿瘤医院,510300

出　　处：《现代消化及介入诊疗》2003年第3期128-129,142,共3页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨肝动脉化学栓塞(TACE)-冷消融-经皮酒精注射(PEI)序贯治疗对不能手术切除性肝细胞癌(HCC)的治疗价值。方法 51例HCC患者先作TACE,2～3周后,作冷消融,再2～3周后作PEI。冷消融治疗采用Cryocare冷冻外科系统完成。结果 48例得到6～20个月的随访,有81.3％的患者治疗后肝内肿瘤缩小,12.5％无变化,6.3％增大;85.3％的患者血清AFP下降,11.8％无明显改变,2.9％升高;87.5％的患者己生存6～20个月,12.5％,生存4～17个月。按Kaplan Meier法计算,半年生存率89.6％,1年生存率80％,1年半生存率66.6％。结论将TACE-冷消融-PEI序贯应用,有相辅相成作用,可作为治疗不能手术切除性HCC的可供选择的安全而有效的方法。Aim To study the therapeutic value of sequential therapy consisted of transarterial chemoembolization(TACE)-cryoablation-percutaneous ethanol injection(PEI) for unresectable hepatocellular carcinoma(HCC). Methods Fifty-one patients with unresectable HCC were given the sequential therapy. TACE was given at first, followed by cryoablation 2～3 weeks later, and lastly PEI was given. Cryoablation was performed with Endocare cryosurgery system, Results Forty eight patients were followed-up for 6～20 months. The decreased volume of intrahepatic tumor was seen in 81.3 percent of patients, no change of tumor in 12.5 percent and increased volume in 6.3 percent. The level of serum alpha-fetoprotein was decreased in 85.3 percent, no significant change in 11.8 percent and increased in 2.9 percent. 87.5 percent of patients were alive for 6～20 months and 12.5 percent of patients died with life span of 4～17 months. According to Kaplan Meier method, the survival rate was 89.6 percent in 6 months, 80 percent in 12 months and 66.6 percent in18 months. Conclusions The sequential therapy consisted of TACE-cryoablation-PEI has complementary value for HCC treatment and may be an alternative modality in selective patients.

关 键 词：化学栓塞 TACE 冷消融 酒精注射 PEI 序贯疗法 肝细胞癌 HCC 病例分析 临床研究 

分 类 号：R735.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]