载药微球经动脉导管化疗栓塞与手术切除治疗Ⅱb期原发性肝癌患者的有效性及安全性分析  

Drug-eluting beads transarterial chemoembolization versus surgical resection for stage Ⅱb primary liver cancer: analysis of clinical effectiveness and safety

作　　者：李建坤[1] 徐卓[1] 王宁[1] 郝哲 LI Jiankun;XU Zhuo;WANG Ning;HAO Zhe(Department of Hepatobiliary Surgery,Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050011,China)

机构地区：[1]河北医科大学第四医院肝胆外科

出　　处：《介入放射学杂志》2019年第12期1181-1184,共4页Journal of Interventional Radiology

摘　　要：目的评价载药微球经动脉导管化疗栓塞(TACE)与手术切除治疗Ⅱb期原发性肝癌患者的疗效差异。方法收集2015年3月至2017年3月住院的Ⅱb期原发性肝癌患者85例,按照治疗方案,分为手术切除(手术组)治疗41例,载药微球化疗栓塞(DEB-TACE)治疗44例。手术组存在术后复发情况,继续TACE治疗;DEB-TACE组首次DEB-TACE治疗后,亦存在继续TACE治疗的情况,将治疗转归详细记录。比较2组治疗后1、3、6个月血清甲胎蛋白(AFP),肝功能,血常规,生存期,肝癌复发情况和药物经济学资料。结果TACE组2年随访期住院总时间及住院总费用低于手术切除组(P<0.05),且TACE组后续TACE治疗次数少于手术切除组。两组患者术后1、3、6个月血清AFP水平及术后2年生存期差异无统计学意义(P>0.05)。结论DEB-TACE治疗Ⅱb期原发性肝癌安全可行,从药物经济学方面考虑DEB-TACE治疗较手术切除治疗更加经济。Objective To compare the curative effect of drug-eluting beads transarterial chemoembolization(DEB-TACE)with that of surgical resection in treating stageⅡb primary liver cancer.Methods A total of 85 patients with stageⅡb primary liver cancer,who were hospitalized between March 2015 and March 2017,were enrolled in this study.According to the treatment plan,the patients were divided into surgery group(n=41,receiving surgical resection)and DEB-TACE group(n=44,receiving DEB-TACE).In the surgery group,TACE would be carried out if the patient had a recurrence after surgical resection.After initial DEB-TACE treatment in DEB-TACE group,TACE was employed in certain cases when necessary,and the treatment outcomes were recorded in detail.At one,3 and 6 months after treatment,the serum alpha-fetoprotein(AFP),liver function,routine test of blood,survival time,recurrence of liver cancer,and pharmacoeconomics data were compared between the two groups.Results During a follow-up period of 2 years,the total hospitalization stay and the total hospitalization expenses in the DEB-TACE group were lower than those in the surgery group(P<0.05),besides,the number of subsequent TACE treatment times in the DEB-TACE group was less than that in the surgery group.No statistically significant differences in AFP levels at one,3 and 6 months after treatment and in 2-year survival rate existed between the two groups(P>0.05).Conclusion For the treatment of stage Ⅱb primary liver cancer,DEB-TACE is clinically safe and feasible.From the point of view of pharmacoeconomics,DEB-TACE is more economical than surgical resection.

关 键 词：原发性肝癌 手术切除 有效性 安全性 

分 类 号：R735.7[医药卫生—肿瘤]