肝转移瘤血供对肝动脉化疗栓塞的近期疗效影响  

The influence of blood supply pattern of hepatic metastases on the short-term effect of TACE

作　　者：李国文[1] 梁赵玉[1] 于小平[1] 古善智[1] 张铁钢[1] 何庆[1] 熊正平[1] 黄满平[1] 

机构地区：[1]湖南省肿瘤医院放诊科,410013

出　　处：《介入放射学杂志》2010年第6期493-496,共4页Journal of Interventional Radiology

摘　　要：目的探讨肝转移瘤的血供对肝动脉化疗栓塞(TACE)疗效的影响。方法回顾性选取经TACE治疗的肝转移瘤58例,观察临床疗效。结果 58例肝转移瘤根据DSA造影表现分为多血供型、中等血供型及少血供型,多血供型14例中有效者(CR+PR)13例(92.9%),中等血供型12例中有效者(CR+PR)10例(83.3%),少血供型32例中有效者(CR+PR)3例(9.4%)。多血供型与少血供型组间、中等血供型与少血供型组间疗效差异有统计学意义(P<0.05),而多血供型与中等血供型组间疗效差别不明显(P>0.05)。从TACE治疗开始,全部病例0.5、1年生存率分别为67.2%、42.3%,多血供型者0.5、1年的生存率分别为100%、78.6%,中等血供型者分别为100%、58.3%,少血供型者分别为40.6%、7.6%。多血供型与少血供型组间、中等血供型与少血供型组间生存期差异有统计学意义(P<0.05),而多血供型与中等血供型组间生存期没有显著性差异(P>0.05)。结论肝TACE对血供丰富的肝转移瘤疗效较好,区分肿瘤血供有利于治疗计划的制定。Objective To discuss the influence of blood supply pattern of hepatic metastases on the short-term effect of transcatheter arterial chemoembolization （TACE）.Methods A total of 58 cases of liver metastases who had been treated with TACE were selected,the clinical data and short-term effects were retrospectively analyzed.Results Based on the DSA findings,58 cases of liver metastases were divided into the hypervascular pattern （n=14）,the isovascular pattern （n=12） and the hypovascular pattern group （n=32）.After TACE the clinical effective rate （CR ＋ PR） of hypervascular,isovascular and hypovascular pattern group was 92.9% （13 /14）,83.3% （10 /12） and 9.4% （3 /32） respectively,with a significant difference existing between hypervascular and hypovascular group as well as between isovascular and hypovascular group （P 0.05）,while no significant difference existing between hypervascular and isovascular group （P 0.05）.The survival rate at half and one year after TACE treatment for all cases was 67.2% and 42.3%,respectively.The survival rate at half and one year for hypervascular,isovascular and hypovascular group was 100% and 78.6%,100% and 58.3%,40.6% and 7.6%,respectively.A significant difference in the survival rate existed between hypervascular and hypovascular group as well as between isovascular and hypovascular group （P 0.05）,while no significant difference existed between hypervascular and isovascular group （P 0.05）.Conclusion TACE shows much better effectiveness for the hypervascular hepatic metastases,and it is very useful for making an appropriate therapeutic plan to distinguish the blood supply pattern of hepatic metastases.

关 键 词：肝肿瘤 肿瘤转移 血液供给 化疗栓塞 治疗效果 

分 类 号：R735.7[医药卫生—肿瘤]