经皮热消融同步经动脉化疗栓塞(TACE)治疗进展期肝内胆管癌(ICC)的临床疗效及预后因素分析  

Percutaneous thermal ablation combined with simultaneous transarterial chemoembolization (TACE) for advanced intrahepatic cholangiocarcinoma (ICC)

作　　者：吴梦飞 宋华丹 颜志平 王小林 王建华 程洁敏 刘凌晓 WU Meng-fei;SONG Hua-dan;YAN Zhi-ping;WANG Xiao-lin;WANG Jian-hua;CHENG Jie-min;LIU Ling-xiao(Department of Interventional Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Medical Imaging,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院介入治疗科,上海200032 [2]上海市影像医学研究所,上海200032

出　　处：《复旦学报（医学版）》2019年第2期226-231,共6页Fudan University Journal of Medical Sciences

摘　　要：目的回顾性分析经皮热消融同步经动脉化疗栓塞(transarterial chemoembolization,TACE)治疗进展期肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)的安全性和有效性,并分析预后因素。方法纳入2010年6月至2017年3月于复旦大学附属中山医院接受经皮热消融同步TACE治疗的进展期ICC患者53例。随访并收集患者的临床资料,根据mRECIST标准评估治疗效果,统计并分析患者手术相关并发症、总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)及预后影响因素。结果 53例患者共行83次经皮热消融同步TACE治疗,有效率(response rate,RR)为80.7%,中位PFS和中位OS分别为7.2和20.9个月。1、2、3年累积生存率分别为72.6%、39.1%和24.3%。6、12及18个月累积无进展生存率分别为58.3%、40.4%和24.2%。多因素分析显示Child-Pugh分级是经皮热消融同步TACE治疗进展期ICC患者生存预后的主要风险因素。1例患者术中出现迷走神经反射,2例患者术后出现肝脓肿,未观察到手术相关死亡病例。结论本研究表明经皮热消融同步TACE治疗进展期ICC是安全有效的。Objective To retrospectively evaluate the safety and efficacy of percutaneous thermal ablation combined with simultaneous transarterial chemoembolization(TACE)for advanced intrahepatic cholangiocarcinoma(ICC).Methods From Jun.,2010 to Mar.,2017,a total of 53 patients with advanced ICC who underwent percutaneous thermal ablation combined with simultaneous TACE in Zhongshan Hospital,Fudan University were enrolled in this study.Their clinical data were collected and reviewed.The tumor response was assessed according to mRECIST criteria.The treatment-related complications,overall survival(OS),progression-free survival(PFS)and prognostic factors were analyzed by SPSS 24.Results The response rate(RR)was 80.7%and the median PFS and the median OS were 7.2 and 20.9 months,respectively.The cumulative survival rates at 1,2,and 3 years were 72.6%,39.1%and 24.3%.The cumulative progression-free survival rates at 6,12,and 18 months were 58.3%,40.4%and 24.2%.Child-Pugh classification was a prognostic factor in patients with advanced ICC who were treated with percutaneous thermal ablation combined with simultaneous TACE.The vagal reflex during procedure occurred in 1 patient,and liver abscesses after treatment happened in 2 patients,while no treatment-related deaths were observed.Conclusions This study demonstrates that percutaneous thermal ablation combined with simultaneous TACE is safe and effective for advanced ICC.

关 键 词：肝内胆管癌(ICC) 热消融技术 经动脉化疗栓塞术(TACE) 同步联合治疗 

分 类 号：R735.7[医药卫生—肿瘤]