暂时阻断肿瘤动脉血流加压灌注治疗乏血供肝癌的单盲随机对照研究中期结果  

Midterm outcome of a half-blind, random, control research： a new therapy that treat hypovascular liver cancer with balloon catheter to block the main artery temporarily, and then pressurize chemoembolization

作　　者：杨永波[1] 程红岩[1] 张亮[1] 陈玉芳[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院放射科,上海200438

出　　处：《中华放射学杂志》2012年第8期724-729,共6页Chinese Journal of Radiology

基　　金：国家科技重大专项基金资助项目（2008ZX10002-025）

摘　　要：目的评价暂时阻断肿瘤动脉血流加压灌注治疗乏血供肝癌介入治疗肝癌的疗效是否优于传统方法及其对肝功能的影响。方法以乏血供肝癌需要行介入治疗的患者为研究对象，随机入组，试验组患者采用试验疗法进行介入治疗，对照组采用传统方法。80例患者完成随访，对其介入前、后的碘油充填情况和肿瘤最大径变化（RECIST标准）进行中期结果分析，同时评价AFP的变化以及试验疗法对肝功能的影响。两组间资料采用Mann—Whitney检验比较其差异，各组内资料采用Friedman检验比较其变化程度，疗效指标间采用Spearmalz非参数相关分析。结果（1）两组患者均符合乏血供肝癌的诊断，且入组基线均衡。（2）碘油充填情况：试验组患者术后各随访节点肿瘤组织内碘油沉积情况均优于对照组，术后第1、3、12个月时两组间的差异有统计学意义（Z值分别为-2．135、-2．939、-2．686，P值均〈0．05），第6个月时2组差异无统计学意义（Z=-1．170，P=0．242）；试验组碘油沉积良好，随访中变化差异无统计学意义（X^2=2．593，P=0．459），对照组差异有统计学意义（X^2=10．886，P=0．012）。（3）肿瘤最大径变化情况：试验组患者术后各随访节点的临床有效率及临床受益率均大于对照组，第3、12个月时两组间的差异均有统计学意义（z值分别为-2．734、-2．733，JP值均〈0．01），第1、6个月两组差异无统计学意义（Z=-1．692和-1．895，P=0．091和0．058）；但试验组和对照组手术前后的肿瘤最大径变化差异均无统计学意义（X^2=5．500，P=0．139；X^2=6．509，P：0．089）。碘油充填与肿瘤最大径变化之间相关性分析，在第3个月时r=0．257，P=0．035。（4）两组患者中，术前AFP在20～1000μL之间者，术后两组患者的随访数据行Pearson卡方检验，X^2=0．882，P=0．644。（5）两组患者的肝功能�Objective To investigate efficacy and effect on liver function of the experimental therapy with balloon catheter to block the main artery temporarily and then pressurize chemoembolization to treat hypovascular liver cancer. Methods Eighty patients with hypovascular liver cancer requiring interventional therapy were randomly divided into two groups. The experimental group was treated with the new therapy and the control group was treated with traditional therapy. The lipiodol-filling status and maximum diameter of the tumor was analyzed for a midterm outcome, and the change of AFP and liver function were evaluated. Mann-Whitney test was used for data between two groups, Friedman test was used for data of each group, and Spearman nonparameter relevant analysis was used for efficacy indexes. Results （1） All Patients have confirmed diagnosis of hypocvascular liver cancer and got balanced baseline. （2） Lipiodol-filling status ： the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 1,3, 12 months （Z = -2. 135, - 2. 939, - 2. 686 ; P = 0. 034,0. 004,0. 007 ）, but no statistically significant difference in 6 month （ Z = - 1. 170 ,P = 0. 242 ）. The status of lipiodol-filling of experimental group （ X2 = 2. 593, P = 0. 459 ） was more stable than control group （ X^2 = 10. 886,P = 0. 012）. （3） Maxinmm diameter of the tmnor： the clinical efficacy and benefit rates of patients from experimental group were higher than that from control group and showed statistically significant difference in 3, 12 months （ Z = - 2. 734, - 2. 733 ;P = 0. 006,0. 006 ） , but no statistically significant difference in 1,6 month （ Z = - 1. 692, - 1. 895 ;P = 0. 091,0. 058 ）. But neither of two groups showed statistically significant difference in change of maximum diameter of the tumor （ Xz = 5. 500,P = 0. 139 ; X^2 = 6. 509,P = 0. 089）. Relation between lipiodol-filling and maximum diameter sh

关 键 词：肝肿瘤 化学栓塞 治疗性 体层摄影术 X线计算机 乏血供 

分 类 号：R735.7[医药卫生—肿瘤]