消化道肿瘤肝转移的肝动脉化疗栓塞疗效分析  

Therapeutic effect of transcatheter arterial chemoembolization in treatment of liver metastases from cancer of gastrointestinal tract

作　　者：管睿[1] 韦永明[1] 宛新安[1] 张章[1] 

机构地区：[1]安徽省芜湖市第二人民医院介入科,241000

出　　处：《中华全科医学》2015年第9期1429-1431,共3页Chinese Journal of General Practice

摘　　要：目的探讨肝动脉化疗栓塞治疗消化道肿瘤肝转移的临床疗效。方法回顾性分析2011年1月—2013年6月收治的原发病灶为食管癌7例，胃癌37例，结、直肠癌36例，胰腺癌11例，胆囊癌3例，胃肠间质瘤2例，共96例消化道肿瘤肝转移癌患者，行经皮股动脉穿刺，选择性肝动脉造影后超选择肿瘤血管灌注化疗药物和超液态碘油栓塞治疗，间隔4～6周重复治疗，96例患者，共行365次化疗栓塞治疗。按照WHO实体瘤的疗效标准，根据随访结果，分析近期疗效和转移后生存率。结果96例消化道肿瘤肝转移癌患者，肝动脉造影表现多血供者41例（42．7％），少血供者55例（57．3％）；临床疗效：总有效率（CR＋PR）为84．37％（81／96），CR为18．75％（18／96），PR为65．62％（63／96）；对其中符合随访条件的65例患者按6个月、12个月、24个月随访，中位生存期14．95个月，6个月生存率98．46％（64／65），12个月生存率67．69％（44／65），24个月生存率18．46％（12／65）；并将原发肿瘤切除者26例和原发肿瘤未切除者39例分2组统计分析，中位生存期分别为18．6个月、12．7个月。按6个月、12个月、24个月随访结果，生存率分别为100．O％、84．6％、30．8％和97．4％、56．4％、10．3％，2组比较差异有统计学意义（P〈0．05）。结论肝动脉化疗栓塞是治疗消化道肿瘤肝转移的有效方法，同时应积极控制原发肿瘤，尤其尽可能行原发肿瘤切除。Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization（TACE） in the treatment of liver metastases from cancer of gastrointestinal tract. Methods The clinical data of 96 cases of liver metastases from cancer of gastrointestinal tract, including 7 cases of esophageal cancer,37 cases of gastric cancer,36 cases of colorectal cancer, 11 cases of pancreatic cancer, 3 cases of gallbladder cancer, and 2 cases of gastrointestinal stromal tumor （GIST） in our hospital January 2011 to June 2013 were analyzed retrospectively. A total of 365 TACE was performed in 96 patients every 4 to 6 weeks. The short-term outcome and survival rate after the treatment were evaluated based on the follow-up results by Response Evaluation Criteria in Solid Tumours （RECIST）. Results Among 96 patients, there were 41 cases （42. 7% ） of hypervascular and 55 cases （57.3 % ）of hypovascular hepatic metastasis according to the results of hepatic arteriography. The overall response rate （ C R ＋ PR） was 84. 37 % （81/96 ）, C R was 18. 75 % （ 18/96 ）, and PR was 65.62% （63/96）. There were 65 cases met the conditions of follow-up visits ,the median survival time was 14. 95 months, the 6,12,24 months survival rate was 98.46% （64/65）, 67.69% （44/65） and 18.46% （ 12/65 ）, respectively. The patients were assigned to two groups, one was primary tumor resection, the other was primary tumor unresectable, and the median survival time was 18.6 months and 12. 7 months,respectively. According to 6 months, 12 months and 24 months fol- low-up results, the survival rates were 100. 0%, 84. 6%, 30. 8% and 97.4%, 56.4%, 10. 3%, there were significant differences in the survival rate （P 〈 0. 05） between the two groups. Conclusion TACE is effective in the treatment of liver metastases from cancer of gastrointestinal tract. In addition, the primary tumor should be controlled actively, as possible as resecting the primary tumors.

关 键 词：消化道肿瘤 肝转移瘤 动脉栓塞 效果 

分 类 号：R735[医药卫生—肿瘤]