经动脉载药微球化疗栓塞治疗大肝癌疗效的影响因素  

Factors influencing the effect of drug-eluting beads transarterial chemoembolization for large liver cancer

作　　者：李臻[1] 李一帆 余鹏 李鑫[1] 张玉元 吴白露 李杰[1] 叶书文 谢炳灿 胡鸿涛[2] 吴刚[1] 任克伟[1] 段旭华[1] 韩新巍[1] LI Zhen;LI Yifan;YU Peng;LI Xin;ZHANGT Yuyuan;WU Bailu;LI Jie;YE Shuwen;XIE Bingcan;HU Hongtao;WU Gang;REN Kewei;DUAN Xuhua;HAN Xinwei(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]河南省肿瘤微创介入工程技术研究中心、郑州大学第一附属医院放射介入科,河南郑州450052 [2]河南省肿瘤医院放射科

出　　处：《介入放射学杂志》2023年第8期781-785,共5页Journal of Interventional Radiology

基　　金：国家自然科学基金项目(U1904143);省部共建重点项目(SBGJ202102099);河南省重大公益专项(201300310400)。

摘　　要：目的 探讨经动脉载药微球化疗栓塞(DEB-TACE)治疗大肝癌效果的影响因素。方法 回顾性分析2016年12月至2020年5月郑州大学第一附属医院接受DEB-TACE治疗的228例大肝癌患者临床资料。观察6、12个月患者客观缓解率(ORR)、总生存期(OS)和1、2年的生存率。采用Cox回归模型分析DEB-TACE治疗患者预后的影响因素。结果 228例患者DEB-TACE术后平均随访36.9个月,最长62个月。首次治疗后6个月与12个月的ORR为55%和43%。患者整体中位OS为11.9个月(95%CI:8.6~14.8)。患者1年的生存率单发与多发(54.1%比36.9%)、单叶分布与双叶分布(54.1%比36.9%)、有包膜与无包膜(56.5%比47.1%)、肿瘤体积≤肝脏体积50%与>50%(53.3%比27.5%),2年的生存率单发与多发(30.9%比23.1%)、单叶分布与双叶分布(31.4%比17.1%)、有包膜与无包膜(43.5%比24.5%)、肿瘤体积≤肝脏体积50%与>50%(32.0%比5.5%),差异均有统计学意义(均P<0.05)。单因素分析显示,肿瘤数目、肿瘤包膜、肿瘤分布、肿瘤占肝脏体积百分比、Child-Pugh分级、门脉癌栓是治疗后患者生存的影响因素;多因素分析显示,肿瘤体积>肝脏体积50%、合并门脉癌栓、肿瘤包膜是治疗后患者生存的影响因素。结论 DEB-TACE治疗大肝癌安全、有效;肿瘤占肝脏体积>50%、门脉癌栓是DEB-TACE治疗大肝癌预后的独立危险因素,而肿瘤包膜是预后的保护因素。Objective To investigate the factors that influence the effect of drug-eluting beads transarterial chemoembolization(DEB-TACE)for large liver cancer(maximum diameter>5 cm).Methods The clinical data of 228 patients with large liver cancer,who received DEB-TACE at the First Affiliated Hospital of Zhengzhou University of China between December 2016 and May 2020,were retrospectively analyzed.The postoperative 6-month and 12-month objective response rate(ORR),and the postoperative one-year and 2-year overall survival(OS)were calculated.Cox regression model was used to analyze the factors influencing patient's outcome after DEB-TACE treatment.Results After DEB-TACE,all 228 patients were followed up for a mean period of 36.9 months with a maximum period of 62 months.The postoperative 6-month and 12-month ORRs after initial treatment were 55%and 43%respectively.The median OS time was 11.9 months(95%CI:8.6-14.8).The one-year survival rates in the patients with single lesion and in the patients with multiple lesions were 54.1%and 36.9%respectively,in the patients who had unilobar lesions and in the patients who had bilobar lesions were 54.1%and 36.9%respectively,in the patients having capsule lesions and in the patients having non-capsule lesions were 56.5%and 47.1%respectively,and in the patients whose lesion volume was≤50%of the total liver volume and in the patients whose lesion volume was>50%of the total liver volume were 53.3%and 27.5%respectively.The 2-year survival rates in the patients with single lesion and in the patients with multiple lesions were 30.9%and 23.1%respectively,in the patients who had unilobar lesions and in the patients who had bilobar lesions were 31.4%and 17.1%respectively,in the patients having capsule lesions and in the patients having non-capsule lesions were 43.5%and 24.5%respectively,and in the patients whose lesion volume was≤50%of the total liver volume and in the patients whose lesion volume was>50%of the total liver volume were 32.0%and 5.5%respectively.The differences in all the abo

关 键 词：大肝癌 化疗栓塞 肿瘤形态 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]