持续经动脉灌注联合栓塞治疗胃癌肝转移疗效评价  

Continuous TAI combined with TAE for the treatment of hepatic metastases from gastric cancer:evaluation of its curative effect

作　　者：王凯[1] 王丽英 刘国兴 倪田强 张宗鹏 刘国斌 夏宝枢[3] 尹春辉[1] WANG Kai;WANG Liying;LIU Guoxing;NI Tianqiang;ZHANG Zongpeng;LIU Guobin;XIA Baoshu;YIN Chunhui(Department of Interventional Medicine, Weifang Municipal Hospital of Traditional Chinese Medicine, Weifang, Shandong Province 261041, China)

机构地区：[1]山东潍坊市中医院介入医学科,261041 [2]山东潍坊市中医院超声科,261041 [3]潍坊市人民医院介入放射科

出　　处：《介入放射学杂志》2018年第12期1160-1162,共3页Journal of Interventional Radiology

摘　　要：目的探讨持续动脉灌注(TAI)联合动脉栓塞(TAE)治疗肝脏转移瘤的可行性、安全性及疗效。方法回顾性分析41例胃癌肝转移患者的临床资料,测量肝脏转移瘤的最大直径,根据m RECIST标准计算近期有效率,统计术后发热、腹痛、恶心等并发症的发生率。结果 41例患者中CR 4例(9.7%),PR 20例(48.7%),SD 8例(19.5%),PD 8例(19.5%),总有效率58.4%。中位生存期25个月,中位无进展生存期17个月。大部分患者在栓塞后出现栓塞后综合征(发热、呕吐、肝区疼痛),Ⅲ度骨髓抑制(发生率12.2%)、腹泻(发生率19.5%)等并发症,给予对症治疗后均好转,无严重并发症发生。结论持续TAI联合TAE治疗肝转移安全、有效,能够显著延长患者的生存期,值得临床推广。Objective To evaluate the feasibility, safety and efficacy of continuous transcatheter arterial infusion(TAI) combined with transcatheter arterial embolization(TAE) in treating hepatic metastases.Methods The clinical data of 41 patients with hepatic metastases from gastric cancer were retrospectively analyzed. The maximum diameter of hepatic metastasis was measured, based on mRECIST standard the short-term effective rate was assessed, and the incidences of postoperative complications, including fever,abdominal pain, nausea, etc., were calculated. Results Of the 41 patients, complete remission(CR) was achieved in 4(9.7%), partial remission(PR) in 20(48.7%), stable disease(SD) in 8(19.5%), and progressive disease(PD) in 8(19.5%). The total effective rate was 58.4%. The median overall survival was25 months, and the median progression-free survival was 17 months. After treatment, most patients developed post-embolization syndrome(fever, vomiting, pain at liver area), bone marrow inhibition of Ⅲ degree(12.2%), diarrhea(19.5%), etc. The complications were improved after symptomatic treatment. No severe complications occurred. Conclusion In treating hepatic metastases from gastric cancer, continuous TAI combined with TAE is safe and effective, it can significantly prolong the survival of patients. Therefore, this therapy is worthy of clinical popularization.

关 键 词：肝转移瘤 经肝动脉灌注化疗栓塞术 介入栓塞 

分 类 号：R735.7[医药卫生—肿瘤]