HIFU联合TACE治疗不能手术切除中晚期肝癌的临床分析  

Clinical Analysis of Middle-late Stage Inoperable Hepatocellular Carcinoma Treated with High Intensity Focused Ultrasound Plus Transcatheter Arterial Chemoembolization

作　　者：金成兵[1] 朱辉[1] 王智彪[1] 伍烽[1] 陈文直[1] 张炼[1] 黎克全[1] 苏海兵[1] 

机构地区：[1]重庆医科大学附属第二医院肿瘤治疗中心,重庆市400010

出　　处：《中国超声医学杂志》2008年第8期741-744,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助项目(No.30171060)

摘　　要：目的探讨高强度聚焦超声(HIFU)联合经导管动脉栓塞治疗(TACE)治疗中晚期肝癌的疗效,并行临床分析。方法随访联合治疗的73例不能手术切除中晚期肝癌和临床分析肝功、门静脉侵犯、肿瘤大小、数目等12个因素。结果总中位生存时间为12个月,1、2、3年生存率依次为49.1%、18.8%、8.4%。单因素分析,年龄、肿瘤大小、肿瘤数目、1997TNM分期、门静脉侵犯有统计学意义(P=0.017、0.000、0.039、0.023、0.02);多因素分析,肿瘤大小有统计学意义(P=0.013)。结论HIFU联合TACE能改善不能手术中晚期肝癌的生存。肿瘤大小是影响预后的独立因素。Objective To study the efficacy of high intensity focused ultrasound （HIFU） plus transeatheter arterial chemoembolizatIon （TACE） in the treatment of patients with middle late stage inoperable hepatocellular carcinoma （HCC） and to analyse clinically. Methods Seventy-three HCC patients （1997 TNM stage ⅢA 25, Ⅳ A 48） who were treated with HIFU plus TACE were followed up. The clinical varibles of gender, age, AFP level, liver function, tumor location, tumor numbers, tumor size, TNM staging, portal vein invasion, ultrasound pathway of HIFU and TACE times were all analyzed. Results Median survival time was 12 months. Survival rates of 1, 2 and 3 year were 49.1%, 18.8% and 8.4%, respectively. On univariate analysis, age （P=0.017）, tumor size （P= 0.000）, tumor numbers （P=0.039）, 1997 TNM staging （P=0.023）, and portal vein invasion （P=0.02） were significant predictors. Tumor size was an independent predictor on multivariate analysis （P = 0.013） Conclusions HIFU plus TACE may prolong survival of middle-late stage inoperable HCC patients. Tumor size was an important predictor.

关 键 词：肝癌 高强度聚焦超声 经导管动脉化学栓塞法 生存分析 

分 类 号：R735.7[医药卫生—肿瘤]