经动脉灌注化疗联合^(125)I粒子条治疗原发性肝癌合并门脉癌栓的疗效分析  

Transcatheter arterial chemoembolization combined with endovascular ^(125)I seed strip implantation for primary hepatocellular carcinoma associated with portal vein tumor thrombus: analysis of curative effect

作　　者：吴林霖[1] 颜志平[2] 张雯[2] 刘清欣[2] 瞿旭东[2] 刘凌晓[2] 王小林[2] 罗剑钧[2] 

机构地区：[1]山东滕州市中心人民医院肿瘤科,277500 [2]复旦大学附属中山医院介入科

出　　处：《介入放射学杂志》2015年第9期776-780,共5页Journal of Interventional Radiology

基　　金：上海市卫计委先进适宜技术推广项目(2013SY060)

摘　　要：目的比较肝动脉化疗栓塞(TACE)联合腔内植入125I粒子条治疗原发性肝癌合并门脉广泛癌栓的疗效。方法对72例接受TACE治疗的原发性肝癌合并门静脉癌栓患者的资料进行回顾性分析,其中32例(A组)在门静脉内植入125I粒子条,同时行TACE治疗肝脏原发灶;40例(B组)仅行TACE治疗。分别对两组患者的门脉癌栓情况、生存期及相关不良事件进行分析。对治疗前后各测量值的改变采用配对样本t检验,计数资料采用χ2检验,用Kaplan-Meier法分析生存时间。结果门静脉内植入125I粒子条的技术成功率为100%,无严重相关不良事件发生。两组患者中位生存期分别为210 d(A组)及141 d(B组),P=0.012,差异有统计学意义。结论门静脉内植入125I粒子条能显著延长原发性肝癌伴门静脉广泛癌栓患者的生存期。Objective To investigate the curative effect of transcatheter arterial chemoembolization （TACE） combined with endovascular ^125I seed strip implantation for the treatment of primary hepatocellular carcinoma （PHC） complicated by extensive portal vein tumor thrombus. Methods The clinical data of 72 patients with PHC complicated by extensive portal vein tumor thrombus were retrospectively analyzed. The patients were divided into group A （n=32） and group B （n=40）. TACE combined with endovascular ^125I seed strip implantation was performed for the patients of group A, while only TACE was employed for the patients of group B. The changes of portal vein tumor thrombus, the survival time and procedure-related adverse events were recorded. The preoperative and postoperative measured values were compared using paired samples t test, the count data were evaluated by Xz test, and the survival time was analyzed with Kaplan-Meier method. Results Technical success rate of portal vein ^125I seed strip implantation was 100%. No serious procedure- related adverse events occurred. The median survival periods of group A and group B were 210 days and 141 days respectively, the difference between the two groups was statistically significant （P=0.012）. Conclusion For the treatment of primary hepatocellular carcinoma complicated by extensive portal vein tumor thrombus, TACE combined with endovascular ^125I seed strip implantation can significantly improve the patient＇s survival time.（J Intervent Radio1, 2015, 24： 776-780）

关 键 词：原发性肝癌 肝动脉化疗栓塞 腔内植入 ^125I粒子条 门静脉 广泛癌栓 

分 类 号：R735.7[医药卫生—肿瘤]