肝动脉化疗栓塞联合静脉化疗治疗儿童巨大肝母细胞瘤瘤体及甲胎蛋白变化  

The change of alpha fetoprotein level and tumor volume of giant hepatoblastoma in children treated by transcatheter arterial chemoembolization combined with intravenous chemotherapy

作　　者：刘新献 非凡 郭严延 周斌 黄穗[1] 刘帆[1] LIU Xinxian;FEI Fan;GUO Yanyan;ZHOU Bin;HUANG Sui;LIU Fan(Imaging Center,Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)影像中心,湖北武汉430016

出　　处：《实用放射学杂志》2022年第5期822-825,共4页Journal of Practical Radiology

摘　　要：目的研究儿童巨大肝母细胞瘤(HB)肝动脉化疗栓塞(TACE)联合静脉化疗后瘤体体积及血清甲胎蛋白(AFP)水平的变化。方法纳入经病理确诊的HB患儿共19例,按照TACE-静脉化疗-手术切除的治疗方案,在TACE治疗4~6周后行静脉化疗3~4个疗程,然后再综合评估手术时机。采取复查CT或腹部立位片的方法观察TACE前、后瘤体体积变化,并记录TACE前、后AFP水平变化。所有患儿随访1~5年。结果所有病例均成功行TACE及静脉化疗,未发生严重并发症。瘤体变化:TACE术后1周肿瘤体积有增大趋势;19例患儿1月后瘤体体积较术前缩小>50%(平均约78.9%);2月后较1月瘤体缩小>25%(平均约55.2%),术后3月较2月平均缩小约8.7%,术后4月较3月平均缩小约74.0%;血清AFP变化:术前平均AFP为213399 ng/mL,术后AFP水平显著下降(P<0.05)。结论TACE联合静脉化疗治疗儿童巨大HB可有效缩小瘤体,降低AFP水平,为手术切除创造更好的条件,从而提高患者的生存率。Objective To study the change of tumor volume and serum alpha fetoprotein(AFP)level in children with giant hepatoblastoma(HB)after transcatheter arterial chemoembolization(TACE)combined with intravenous chemotherapy.Methods A total of 19 patients with HB who were confirmed by pathology were included.According to the sequential treatment plan of TACE-intravenous chemotherapy-surgery,3~4 courses of intravenous chemotherapy were performed 4-6 weeks after TACE treatment,and then the timing of the operation was evaluated comprehensively.The changes of tumor volume before and after TACE were observed by follow-up of CT or abdominal orthostatic radiograph,and the AFP level before and after TACE were also recorded.All patients were followed up for 1-5 years.Results TACE and intravenous chemotherapy were successfully performed on all patients without serious complications.The tumor volume tended to increase 1 week after TACE.One month after TACE,the tumor volume in 19 cases decreased by more than 50%(average 78.9%)compared with that before TACE;and 2 months after TACE,the tumor volume decreased by 25%(average 55.2%)compared with that 1 month after TACE.Three months and 4 months after TACE,the tumor volume decreased by an average of 8.7%and 74.0%,respectively,compared with the previous time.The mean AFP level was 213399 ng/mL before TACE,and significantly decreased after TACE(P<0.05).Conclusion TACE combined with intravenous chemotherapy can effectively shrink the tumor size and reduce AFP level in the treatment of giant HB in children,which creates better condition for surgical resection and improves the survival rate of patients.

关 键 词：儿童 肝母细胞瘤 肝动脉化疗栓塞 静脉化疗 瘤体体积 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学] R818.051