载药微球肝动脉栓塞与手术切除治疗Ⅱb期原发性肝癌的近远期疗效比较  

Effect of Drug-eluting Beads Transcatheter Arterial Chemoembolization and Surgical Resection on Short-term and Long-term Efficacy of StageⅡb Primary Liver Cancer

作　　者：王松 王文超 杨俊驰 李阿建 李越 WANG Song;WANG Wen-chao;YANG Jun-chi(Shanghai Yangpu District Central Hospital(Yangpu Hospital,Tongji University),Shanghai 200090)

机构地区：[1]上海市杨浦区中心医院(同济大学附属杨浦医院),上海200090

出　　处：《医学临床研究》2021年第12期1787-1790,共4页Journal of Clinical Research

摘　　要：【目的】比较载药微球肝动脉栓塞(TACE)与手术切除治疗Ⅱb期原发性肝癌的近远期疗效。【方法】本院收治的68例首诊Ⅱb期原发性肝癌患者随机分为A组和B组,各34例。B组进行手术切除,A组接受CalliSpheres聚乙烯醇栓塞微球经导管动脉化疗栓塞(DEB-TACE),两组复发后均接受TACE治疗。比较两组无进展生存期(DFS)、总生存期(OS)、治疗前后血生化资料、并发症情况和近期疗效。【结果】两组治疗后1个月和3个月的客观缓解率,疾病控制率相比较差异均无显著性(P>0.05)。两组治疗3个月和治疗6个月后AFP、TBIL、AST、ALT、VEGF、bFGF均较治疗前降低(P<0.05);治疗3个月两组ALB较治疗前增高(P<0.05)。治疗后2年内两组平均累积TACE治疗次数比较差异无显著性(P>0.05)。两组并发症发生率比较差异无显著性(P>0.05)。A组和B组累积DFS率、累积OS率比较差异均无显著性(P>0.05)。【结论】DEB-TACE治疗Ⅱb期原发性肝癌效果显著,与手术切除的效果及预后相当。【Objective】To compare the near-and long-term efficacy of drug-loaded microspheres through transcatheter hepatic arterial embolization(TACE)and surgical resection for stageⅡb primary liver cancer.【Methods】A total of 68 patients with primary liver cancer of stageⅡb were random divided into groups A and B,with 34 cases each.The group B underwent surgical resection,while group A received CalliSpheres drug-eluting beads transarterial chemoembolization(DEB-TACE).Both groups received transarterial chemoembolization after relapse.The progression-free survival(DFS),overall survival(OS),blood biochemical data before and after treatment,complications,and short-term efficacy were compared between the two groups.【Results】There were no significant differences in objective remission rate and the disease control rate at 1 month and at 3 months after treatment between the two groups(P>0.05).Compared with before treatment,the levels of VEGF,bFGF,AFP,TBIL,AST and ALT in both groups decreased after 3 months and after 6 months of treatment(P<0.05),while ALB increased after 3 months of treatment(P<0.05).There was no significant difference in the average cumulative number of TACE treatments between the two groups within 2 years after treatment(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).There were no significant differences in cumulative DFS rate and cumulative OS rate between group A and group B(P>0.05).【Conclusion】DEB-TACE is effective in the treatment of stageⅡb primary liver cancer,which is equivalent to the effect and prognosis of surgical resection,while DEB-TACE can reduce the number of TACE treatments and reduce the cost of hospitalization.

关 键 词：肝肿瘤/外科学 栓塞 治疗性 肝动脉 微球体 药物载体 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]