经导管化疗栓塞联合经皮微波消融治疗中晚期肝癌64例的预后分析  

Transcatheter arterial chemoembolization combined with percutaneous microwave ablation for the treatment of intermediate- advanced hepatocellular carcinoma: analysis of prognostic factors in 64 cases

作　　者：万豪光[1] 许伟[1] 徐浩[1] 顾玉明[1] 祖茂衡[1] 王勇[1] 宗迎迎 

机构地区：[1]徐州医学院附属医院放射科,221002

出　　处：《介入放射学杂志》2014年第6期477-481,共5页Journal of Interventional Radiology

摘　　要：目的探讨经导管肝动脉化疗栓塞(TACE)联合经皮微波消融术(MWA)治疗中晚期肝癌预后的影响因素。方法 2011年1月—2012年7月,64例中晚期肝癌患者行TACE联合MWA治疗,收集14项可能影响预后的因素作回顾性单因素与多因素分析。单因素分析采用Kaplan-Meier模型及Logrank检验,多因素分析采用Cox比例风险模型。结果 64例中晚期肝癌患者治疗后1、1.5、2年总生存率分别为75.8%、48.4%、33.9%。单因素分析及Cox回归分析结果显示肿瘤大小、肿瘤数目、门静脉癌栓、血清AFP值、肿瘤期别、服用索拉菲尼等6项因素与预后有关。结论肿瘤大小、肿瘤数目、门静脉癌栓、血清AFP值、肿瘤期别是影响介入综合治疗预后的危险因素,服用索拉菲尼是影响预后的保护性因素。Objective To investigate the prognostic factors affecting the outcome of patients with intermediate-advanced hepatocellular carcinoma （HCC） receiving transcatheter arterial chemoembolization （TACE） combined with percutaneous microwave ablation （MWA）. Methods During the period from January 2011 to July 2012 at authors’ hospital, a total of 64 patients with intermediate-advanced HCC were treated with TACE together with MWA. Fourteen potential variables which might affect the prognosis were colleted and were retrospectively analyzed. Kaplan-Meier model and log-rank test were used for single factor analysis, while Cox regression model was used for multiple factor analysis. Results The one-year, 1.5-year and 2-year overall survival rates were 75.8%, 48.4% and 33.9%, respectively. Single factor analysis and Cox regression analysis indicated that six factors, i.e. tumor size, number of tumors, portal vein tumor thrombus, serum α-fetoprotein level, tumor staging and oral administration of sorafenib, bore a relationship to the prognosis. Conclusion The tumor size, number of tumors, portal vein tumor thrombus, serum α-fetoprotein level and tumor staging are risk factors influencing the results of interventional comprehensive therapy , while oral administration of sorafenib is a protective factor for the prognosis.

关 键 词：癌 肝细胞 化疗栓塞 微波消融 预后 

分 类 号：R735.7[医药卫生—肿瘤]