肝动脉化疗栓塞联合经皮微波凝固治疗晚期肝癌  

Combined use of TACE and PMCT for the treatment of advance stage hepatic carcinoma

作　　者：马爱英[1] 沈杰[1] 王海洁[1] 刘秋如[1] 王亚进[1] 

机构地区：[1]解放军第四五五医院肿瘤科,上海200052

出　　处：《介入放射学杂志》2007年第3期201-203,共3页Journal of Interventional Radiology

摘　　要：目的评价肝动脉化疗栓塞+B超引导下经皮微波凝固治疗＞5 cm肝癌的疗效及安全性。方法对68例肝肿瘤＞5 cm的患者进行TACE+PMCT治疗。随访CT、B超及肿瘤相关化验检查。结果68例中肿瘤达到完全消融3例(4．4%),肿瘤消融范围＞50%或瘤灶缩小30%以上59例(86．8%),消融范围＜50%,肿瘤缩小不足30%6例(8．8%)。AFP增高45例,术后下降＞50%者42例(93．3%),CEA增高37例,下降＞50%者28例(75．7%),CA19-9增高29例,下降＞50%者23例, (93．1%)。生存期4～6个月3例,＞6个月31例,＞12个月34例,其中2例已终止治疗24个月,随访至今无复发。无相关性死亡发生。结论TACE+PMCT治疗肝肿瘤＞5 cm的患者是安全有效的手段。Objective To evaluate the efficacy and safety of transarterial chemoembolization （TACE） combined with sonographically guided percutaneous microwave coagulation therapy （PMCT）for hepatic carcinoma with diameter 〉 5.0 cm. Methods We retrospectively reviewed 68 cases of hepatic cai＇cinoma with diameter 〉 5.0 cm under treatment of TACE combined with PMCT. CT, USG and correlated laboratory tests of hepatic carcinoma were carried out. Results Among 68 cases, complete ablation were 5 cases （5/68）, tumor ablation area more than 50% or tumor shrinkage less than 30% were 59 cases（59/ 68）, tumor ablation area less than 50% or tumor shrinkage more than 30% were 6 cases（6/68）. Forty five cases with high AFP descended more than 50% after the procedure in 42 cases（93.33%）. Thirty seven cases and 29 cases with increase of CEA and CA19-9 decreased to 28 （75.97%） and 23 （93.10%） cases with corresponding index decreasing more than 50% respectively. Survival time reached 4 - 6 months in 3 cases, more than 6 months for 31 cases, more than 12 months of 34 cases. Two cases among them showed no recurrence up to now after stoppage of treatment for 24 months and finally no correlative mortality occurred. Conclusion TACE combined with sonographically guided PMCT for hepatic carcinoma with diameter more than 5 cm is safe and effective.

关 键 词：肝癌 肝动脉栓塞 微波治疗 

分 类 号：R735.7[医药卫生—肿瘤]