联合介入治疗中晚期原发性肝癌远期疗效及影响因素分析  

Long-term Results and Prognostic Affecting Factors of Combined Interventional Therapies for Treatment of Intermediate and Advanced Primary Liver Cancer

作　　者：倪嘉延[1] 许林锋[1] 陈耀庭[1] 孙宏亮[1] 谭绮尹[1] 胡仁美[1] 

机构地区：[1]中山大学孙逸仙纪念医院介入放射科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2013年第5期734-738,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(10151008901000182)

摘　　要：[目的]评价经导管动脉化疗栓塞（TACE）联合微波消融（MWA）治疗中晚期原发性肝癌的远期临床疗效及主要影响因素.[方法]本研究随访2005年1月至2011年12月间在中山大学孙逸仙纪念医院介入科接受TACE联合MWA治疗的86例中晚期原发性肝癌患者,其中男性76例,女性10例,年龄11～78（54.97＋15.43）岁.利用SPSS17.0版统计软件,单因素分析采用Kaplan-Meier方法及Log-rank检验,多因素分析采用Cox逐步回归方法.[结果]本组患者中位生存时间为21.5个月,1、2、3、5年累积生存率分别为72.3％、44.7％、31.5％、13.1％.单因素分析与预后有关的因素有肿瘤大小、BCLC分期、Child-Pugh分级、门脉癌栓、动静脉瘘、MWA治疗次数、ECOG评分及靶向药物治疗.Cox逐步回归多因素分析与预后有关并具有显著意义的因素变量为肿瘤大小、BCLC分期、门脉癌栓、MWA治疗次数、ECOG评分及靶向药物治疗.[结论]肝癌靶向药物治疗及适当重复MWA治疗可延长中晚期肝癌患者的生存时间,为预后保护性因素;大肝癌、临床分期较差及门脉癌栓为预后危险性因素.[ Objective ] To study the long-term results and the prognostic factors of the impact of the combination of transcatheter arterial chemoembolization （TACE） and microwave ablation （MWA） for treatment of intermediate and advanced primary liver cancer （PLC）. [Methods] A total of 86 cases underwent the combination of TACE and MWA with complete data were selected from January 2005 to December 2011 in Sun Yat-sen Memorial Hospital. 76 patients were men and 10 patients were women. Age ranged from 11 to 78 years old （mean ＋ SD, 54.97＋15.43 years）. Single-factor analysis and multivariate analysis was performed on prognostic factors using Kaplan-Meier, Log-rank, and Cox regression analysis by SPSS software （version 17.0）. [Results] The median survival time was 21.5 months and the 1-, 2-,3- and 5-year overall survival rates was 72.3%, 44.7%, 31.5%, and 13.1%, respectively. Univariate analysis showed that tumor size, BCLC class, Child-Pugh class, portal vein tumor thrombus, arteriovenous fistula, tumor stain, frequency of MWA treatment, ECOG grade and targeted drug therapy were the relative factors. Prognostic factors in multivariate analysis were tumor size, BCLC class, portal vein tumor thrombus, frequency of MWA treatment, ECOG grade and targeted drug therapy. [ Conclusions ] Targeted drug therapy and retreatment of MWA can prolong the overall survival time. Large PLC, advanced BCLC class and portal vein tumor thrombus is the risk prognostic factors for patients.

关 键 词：原发性肝癌 经导管动脉化疗栓塞 微波消融 预后 回归分析 

分 类 号：R735.7[医药卫生—肿瘤]