CT引导下^125I放射性粒子植入治疗肝癌门静脉癌栓的疗效评价  

Evaluation of CT-guided ^(125)I seed implantation combined with transcatheter arterial chemoembolization in treating portal vein tumor thrombus associated with hepatocellular carcinoma

作　　者：翁志成[1] 杨维竹[1] 江娜[1] 郑曲彬[1] 黄兢姚[1] 黄宁[1] 申权[1] 吴正忠[1] 谢杭[1] 

机构地区：[1]福州福建医科大学附属协和医院介入科,350001

出　　处：《介入放射学杂志》2010年第7期535-539,共5页Journal of Interventional Radiology

摘　　要：目的探讨CT引导下125I放射性粒子植入联合肝动脉化疗栓塞术(TACE)治疗肝癌合并门静脉癌栓(PVTT)的疗效。方法回顾性分析原发性肝癌合并PVTT患者58例,A组(26例)行TACE结合CT引导下125I放射性粒子植入局部放射治疗;B组(32例)单纯行TACE。对比两组疗效。结果 A组1、2年生存率分别为42.3%、23.0%,平均生存期15.5个月,完全缓解(CR)3例,部分缓解(PR)9例,总有效率(CR+PR)为46.2%(12/26)。B组1、2年生存率分别为21.9%、6.3%,平均生存期7.5个月CR2例,PR6例,CR+PR为25.0%(8/32)。A组的生存率及总有效率显著高于B组(P<0.05)。结论 TACE联合CT引导下125I放射性粒子植入治疗肝癌门脉癌栓能明显提高其疗效,并具有创伤少,并发症少等优点。Objective To discuss the therapeutic effect of CT-guided ^125I seed implantation combined with transcatheter arterial chemoembolization（TACE） for the treatment of portal vein tumor thrombus（PVTT） associated with hepatocellular carcinoma（HCC）.Methods A total of 58 patients with confirmed HCC accompanied by PVTT were enrolled in this study.Of the 58 patients,CT-guided ^125I seed implantation together with TACE was performed in 26（group A）,while only TACE was employed in 32（group B）.The clinical data were retrospectively analyzed and the therapeutic results were compared between two groups.Results For group A,the one-year and two-year survival rate was 42.3% and 23.0% respectively,with a mean survival time of 15.5 months.Of the 26 patients in group A,the complete remission（CR） was obtained in 3,partial remission（PR） in 9,with a total effective rate（CR ＋ PR） of 46.2%（12 /26）.While in group B,the one-year and two-year survival rate was 21.9% and 6.3% respectively,with a mean survival time of 7.5 months.And CR was obtained in 2 cases,PR in 6 cases,with a total effective rate（CR ＋ PR） of 25%（8/32）.Both the survival rate and the total effectiveness of group A were significant higher than that of group B（P 0.05）.Conclusion As a minimally-invasive technique with less sufferings and fewer complications,CT guided ^125I seed implantation combined with transcatheter arterial chemoembolization can markedly improve the therapeutic effect for portal vein tumor thrombus associated with hepatocellular carcinoma.

关 键 词：肝细胞癌 门静脉癌栓 碘放射性核素 疗效 

分 类 号：R735.7[医药卫生—肿瘤]