化疗栓塞治疗原发性肝癌合并下腔静脉及右心房癌栓疗效观察  

Transcatheter-arterial chemoembolization for the treatment of primary hepatic carcinoma with a tumor thrombus in the inferior vena cava and right atrium

作　　者：常旭 刘吉兵 吴会勇 张健鑫 孙鹏 张林 谢印法 CHANG Xu;LIU Ji-bing;WU Hui-yong;ZHANG Jian-xin;SUN Peng;ZHANG Lin;XIE Yin-fa(Tenth Department of Surgery,Shandong Cancer Hospital Affiliated to Shandong University,Jinan 250117,P.R.China)

机构地区：[1]山东大学附属山东省肿瘤医院外十科,山东济南250117

出　　处：《中华肿瘤防治杂志》2019年第1期52-55,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的原发性肝癌合并下腔静脉-右心房(inferior vena cava-right atrium,IVR-RA)癌栓发病率低,预后差,目前尚无统一有效的治疗方法。本研究观察化疗栓塞治疗原发性肝癌合并IVR-RA癌栓患者的安全性及其疗效。方法回顾性分析2014-01-01-2018-01-01 19例就诊于山东大学附属山东省肿瘤医院介入科并行介入治疗的原发性肝癌合并IVR-RA癌栓患者的生存期及术后并发症。结果患者平均年龄为54.0 (41～79)岁。中位生存期为10.0 (2～36)个月,1、2年生存率分别为43.5%及31.1%。同时,TACE联合索拉非尼或阿帕替尼的患者中位生存期为16.0(3～36)个月,单纯TACE治疗的患者,中位生存期为6.0(2～28)个月,生存期差异无统计学意义,χ2=2.016,P=0.156。术中及术后多为轻微并发症,未见癌栓脱落等严重并发症。结论化疗栓塞治疗原发性肝癌合并IVR-RA癌栓患者,安全有效,近期疗效确切,可一定程度延长患者生存期及改善患者生活质量。OBJECTIVE The presence of primary hepatic carcinoma(PHC)with a tumor thrombus in the inferior vena cava and right atrium(IVR-RA)is rare and has poor prognosis.In addition,there is no standard and effective treatment for these patients.The objective of study was to assess the feasibility,safety and effectiveness of trans-arterial chemoembolization(TACE)in the treatment of PHC with a tumor thrombus in the IVC and RA.METHODS From January2014 to January 2018,19 cases of PHC patients with a tumor thrombus in the IVC and RA were carried out with TACE.Clinical adverse events and overall survival were analyzed.RESULTS Patients’ mean age was 54.0(41-79)years old.The median overall survival(OS)was 10.0(2-36)months.The 1-and 2-year survival from the time of TACE was43.5% and 31.1% respectively.The median OS of the patients performed with TACE and sorafenib or apatinib were16.0 months,while the patients treated with TACE alone were 6.0 month.There was no statistical significance(χ^2=2.016,P=0.156).Complications in this study were mild,severe complications caused by technique were not detected.CONCLUSION The TACE can be safely performed and may improve the prognosis of the PHC patients to some extent with a tumor thrombus in the IVC-RA.

关 键 词：原发性肝癌 化疗栓塞 下腔静脉癌栓 靶向药物 

分 类 号：R735.7[医药卫生—肿瘤]