经肝动脉栓塞化疗联合门静脉化疗对预防肝细胞癌切除术后复发的研究  

Curative effect observation of transcatheter arterial chemoembolization combined with portal vein chemotherapy after resection with hepatocellular carcinoma patients

作　　者：陈安[1] 杨振宇[1] 杜锡林[1] 杨涛[1] 谭凯[1] 贺小军[1] 雷世雄 

机构地区：[1]第四军医大学唐都医院普通外科,陕西西安710038

出　　处：《西部医学》2016年第7期925-927,931,共4页Medical Journal of West China

基　　金：国家自然科学基金(81172287)

摘　　要：目的观察经肝动脉栓塞化疗（TACE）联合门静脉化疗（PVC）预防肝细胞癌根治术后复发的疗效。方法回顾性分析2009年6月~2013年7月期间60例肝细胞癌（HCC）首次行根治性切除术后复发再次实施相应治疗的患者资料。根据术后治疗情况分为两组进行对比分析。联合门静脉化疗组22例（A组）,为手术切除后辅以PVC＋TACE治疗：术后辅以单纯肝动脉化疗组38例（B组）。结果联合门静脉化疗组与单纯TACE化疗组术后1年、2年复发率分别为27.3%与31.6%（P〉0.05）和54.5%与73.7%（P〈0.05）,两组1、2、3年生存率分别为77.3%、65.8%与54.5%和34.2%、31.8%与23.7%（P〈0.05）,两组患者1年复发率无统计学意义,但联合化疗组2年复发率明显低于单纯TACE组（P〈0.05）;生存率方面来看,联合化疗组1、2、3年均比单纯TACE组高,差异具有统计学意义。结论肝细胞癌根治性切除术后辅以经肝动脉和门静脉系统的联合化疗方案能够有效降低患者的复发率和提高生存率,其疗效于术后1年更为明显,可作为临床治疗的较好选择。Objective To observe the efficacy of TACE combined with PVC underwent the patectomy of hepatocellular carcinoma（HCC）patients.Methods From June 2009 to July 2013,The clinical data of 60 patients were retrospectively studied,which were divided into A group（TACE＋PVC,22cases）and B group（TACE,28cases）according to postoperative adjuvant chemotherapy scheme.All of these patients underwent resection surgery and was confirmed by pathological examination for HCC.Results The 1-and 2-year recurrence rates of A group and B group were 27.3% and31.6%（P0.05）,54.5% and 73.7%（P0.05）.The 1-,2-and 3-year overall survival rates of A group and B group was 77.3% and 65.8%,54.5% and 34.2,31.8% and 23.7%（P0.05）,respectively.1-year recurrence rate of two groups had no obvious statistical significance.However,2-year recurrence rates and 1-,2-,3-year survival rates between A and B group were significant differences.A group had a lower 2-year recurrence rates and a higher overall survival rates.Conclusion Post-operation TACE＋PVC are effective measures for reducing the recurrence rates and increasing survival rates of patients with HCC.Its overall clinical effect is obviously improved in postoperative 1year.

关 键 词：肝细胞癌 肝动脉化疗栓塞术 门静脉化疗 预后 

分 类 号：R735.7[医药卫生—肿瘤]