原发性肝癌综合介人治疗后存活5年以上56例患者临床分析  

Clinical analysis of 56 cases of primary liver cancer of over 5 years survival after comprehensive interventional therapy

作　　者：刘嵘[1] 王建华[1] 颜志平[1] 程洁敏[1] 钱晟[1] 龚高全[1] 刘清欣[1] 陈颐[1] 罗剑钧[1] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032

出　　处：《介入放射学杂志》2007年第3期155-158,共4页Journal of Interventional Radiology

摘　　要：目的分析有关原发性肝癌综合性介入治疗远期疗效的关键因素。方法回顾性分析56例经综合介入治疗后存活5年以上的肝癌患者的临床治疗和随访资料。结果介入治疗前患者肿瘤分期Ⅰ期20例,Ⅱ期35例,Ⅲ期1例,肝功能分级Child A级36例,B级20例,C级0例。单发病灶32例,多发病灶24例,弥漫型0例。肿瘤直径≤3 cm、3～5 cm、5～10 cm和＞10 cm者分别为10、20、19和7例。肝内原发肿瘤33例(58．9%)采用TACE治疗,23例(41．1%)采用TACE联合其他治疗,其中联合PEI治疗11例,联合射频治疗4例,联合外放疗1例;联合Ⅱ期手术切除7例。随访期间,对24例肝内复发患者和17例远处转移患者行相应治疗,20例次还行并发症的介入治疗。所有患者均存活5年以上,其中3例存活10年以上。结论肿瘤分期、肝功能状况、治疗中采用规范TACE治疗、TACE联合其他治疗、肿瘤复发和转移治疗以及介入并发症的治疗是提高肝癌综合性介入治疗远期疗效的关键因素。Objective To analyze the key factors on long-term effect for comprehensive interventional therapy of primary liver cancer. Methods The clinical data, therapeutic protocols and follow-up of 56 patients with primary liver cancer survived for more than 5 years after comprehensive interventional therapy were analyzed retrospectively. Results Before TACE, 20 patients were in clinical stage Ⅰ , 35 were in stage Ⅱ and one was in stage Ⅲ, including hepatic function of grade A（36 cases）, grade B（20 eases）, and grade C （0 case）. The tumor patterns were consisted of mononodular type（32 cases）, muhinodular type（24 cases）, and diffuse type（0 cases）. The diameter of tumor demonstrated less than 3 cm（10 cases）, 3 - 5 cm（20 cases）, 5 - 10 cm（19 cases）and more than 10 cm（7 cases）. Thirty-three cases（58.9%）were treated by only TACE for the original lesions, while 23 cases （41.1%）were treated by TACE combined other treatment including TACE combined PEI（11 cases）, TACE combined RFA（4 cases）, TACE combined radiotherapy（one case）, and TACE combined R-staged resection（7 cases）. During follow-up, 24 patients with hepatic recurrence and 17 cases of distal metastasis were treated by TACE and other anti-tumor treatment. Complications after interventional therapy in 20 cases were also treated. All cases survived for more than 5 years after interventional therapy including 3 more than 10 years. Conclusions Tumor factors, liver function, standardized TACE, combination of TACE with other anti-tumor therapy, treatment of hepatic recurrence and distal metastasis and complications are the key points to improve the long-term survival rate for primary liver cancer treated by comprehensive interventional therapy.

关 键 词：肝肿瘤 化疗栓塞 综合性介入治疗 远期疗效评价 

分 类 号：R735.7[医药卫生—肿瘤]