TACE和TAI在单发原发性肝癌切除术后辅助性介入治疗中的效果比较  

Effects of TACE and TAi in adjuvant interventional therapy for single primary liver cancer after resection

作　　者：金沅武[1] 赵媛[2] 李亚威[3] JIN Yuan-wu;ZHAO Yuan;LI Ya-wei(Department of Hematology,Central Hospital of Zibo Mining Group Co., Ltd., Zibo, Shandong 255120, China;Department of Thoracic Surgery, Central Hospital of Zibo Mining Group Co., Ltd., Zibo, Shandong 255120, China;Department Hepatobiliary Surgery The First Hospital of Hebei Medical University, Shijiazhuang 050000, China)

机构地区：[1]山东省淄博矿业集团有限责任公司中心医院肿瘤血液科,山东淄博255120 [2]山东省淄博矿业集团有限责任公司中心医院胸外科,山东淄博255120 [3]河北医科大学第一医院肝胆外科,河北石家庄050000

出　　处：《肝胆胰外科杂志》2017年第2期116-119,共4页Journal of Hepatopancreatobiliary Surgery

基　　金：卫生部医药卫生科技项目(13010520120353)

摘　　要：目的比较经肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)和肝动脉灌注化疗(transcatheter arterial infusion,TAI)在单发原发性肝癌切除术后辅助性介入治疗中的效果。方法 94例行手术切除的单发原发性肝癌患者根据术后辅助性介入方法不同,分为TACE组(n=49)和TAI组(n=45),同期选取术后均未行预防性介入治疗的30例作为对照组。TAI组采取单纯化疗药物灌注化疗,TACE组采用化疗药物与碘油混悬剂,所有患者随访至2016年9月,比较三组患者术后肿瘤复发情况,利用Kaplan-Meier分析三组患者无复发生存期。结果 TACE组和TAI组患者术后1年复发率分别为14.3%和13.3%,均低于对照组的46.7%,差异有统计学意义(P<0.05);TACE组患者术后2年和3年复发率分别为21.4%和30.3%,均低于TAI组和对照组,差异均有统计学意义(P<0.05)。对于中位无复发生存期,TACE组34.30个月,TAI组24.71个月,对照组12.90个月,Log-Rank检验显示差异具有统计学意义(χ2=34.228,P<0.001)。结论相比于TAI,TACE可有效降低患者术后2年和3年复发率,延长患者无复发生存期,有助于改善患者预后。Objective To investigate the effects of TACE and TAI in adjuvant interventional therapy forsingle primary liver cancer after resection.Methods Ninety-four cases of patients with single primary liver cancerunderwent surgical resection were divided into TACE group(n=49)and TAI group(n=45),according to themethods of adjuvant interventional therapy after resection.In the same period,30cases of patients who did notaccept adjuvant interventional therapy were selected as the control group.Patients in TAI group were taken singlechemotherapeutic agent,while patients in TACE group were taken suspensions of chemotherapeutic agent andiodized.All patients were followed up until Sep.2016.The tumor recurrences in the three groups were compared.The relapse-free survival times in the three groups were analyzed using Kaplan-Meier analysis.Results The oneyearrecurrence rates in the TACE group and TAI group were14.3%and13.3%,respectively,which were lowerthan that in the control group(46.7%),the differences were statistically significant(P<0.05).The2-year and3-year recurrence rate in TACE group were21.4%and30.3%,respectively,which were lower than those in theTAI group and control group,the differences were statistically significant(P<0.05).The median relapse-free survivaltime in TACE group was34.30mon,while in TAI group and control group were24.71mon and12.90mon,respectively.Log-Rank test showed that the differences were statistically significant(χ2=34.228,P<0.001).ConclusionCompared with TAI,TACE can effectively reduce2-year and3-year recurrence rate,prolong relapsefreesurvival time and improve the prognosis of hepatocellular carcinoma patients after resection.

关 键 词：原发性肝癌 手术切除 经肝动脉化疗栓塞术 肝动脉灌注化疗 

分 类 号：R735.7[医药卫生—肿瘤]