肾癌根治术前肾动脉化疗-栓塞的疗效观察  

A study of preoperative transarterial chemo-embolization for renal cell carcinoma

作　　者：周俊[1] 袁建华[1] 刘子江[1] 俞文强[1] 蔡学祥[1] 胡庭扬[1] 邹强[2] 

机构地区：[1]310014 杭州，浙江省人民医院放射科 [2]310014 杭州，浙江省人民医院泌尿外科

出　　处：《中华泌尿外科杂志》2001年第5期269-271,共3页Chinese Journal of Urology

摘　　要：目的　评价根治术前化疗 栓塞对肾癌预后的影响。　方法　对 42例经术后病理证实并获随访的肾癌患者临床资料进行回顾性分析。分两组 :根治术前化疗 栓塞组 2 2例 (A组 ) ;单纯根治术组 2 0例 (B组 )。A组经肾动脉灌注化疗药物后 ,用碘油和化疗药物混悬剂行末梢血管栓塞 ,用明胶海绵行中心性栓塞 ,化疗 栓塞后 2～ 5d行患肾根治性切除。　结果　A组术中出血量 15 0～6 0 0ml,平均 2 45ml;手术时间 2 .0～ 5 .5h ,平均 2 .8h ,均少于B组。A组 1、3、5和 10年生存率分别为 86 .4%、72 .7%、5 7.1%和 39.0 %。两组比较 ,差别均有显著性意义 (P <0 .0 5 )。Cox模型分析表明根治术前化疗 栓塞是影响肾癌预后的独立因素。　结论　肾癌根治术前化疗 栓塞安全有效 ,对肾癌的治疗有重要意义。Objective To evaluate the prognostic efficacy of preoperative transarterial chemo-embolization for renal cell carcinoma. Methods A total of 42 cases of renal cell carcinoma confirmed by operation and pathology were retrospective studied.22 cases were allotted to preoperative transarterial chemo-embolization and 20 cases by operation alone.Preoperative transarterial chemo-embolization was performed by infusing anticancer drugs,followed by emulsion of iodized oil and anticancer drugs for peripheral vessels embolization and then by injecting gelatin sponge into the renal artery.Surgery was performed within 2～5 days after transarterial chemo-embolization. Results Preoperative transarterial chemo-embolization made resection easier.The 1～,3～,5～ and 10- year survival rates were 86.4%、 72.7%、 57.1% and 39.0% in the preoperative transarterial chemo-embolization group,higher than the operation alone group,P< 0.05.The Cox model analyse showed preoperative transarterial chemo-embolization was an independent factor affecting the long term survival rate of renal cell carcinoma. Conclusions Preoperative transarterial chemo-embolization is a safe and effective method in the treatment of renal cell carcinoma.

关 键 词：肾肿瘤 肾癌 根治术 肾动脉化疗 肾动脉灌注 疗效 

分 类 号：R737.11[医药卫生—肿瘤] R730.5[医药卫生—临床医学]