肝癌根治性切除术后区域辅助化疗预防转移复发的前瞻性研究  

Efficacy of hepatic regional chemoembolization via implanted drug delivery system in prevention of metas- tasis and recurrence after radical resection of primary liver cancer

作　　者：吴志全[1,2] 樊嘉[1,2] 邱双健[1,2] 周俭[1,2] 贺轶峰[1,2] 汤钊猷[1,2] 

机构地区：[1]复旦大学肝癌研究所 [2]中山医院

出　　处：《中华肝胆外科杂志》2003年第11期641-644,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的 分析原发性肝癌根治性切除术后经皮下植入式药物输注系统(DDS)区域辅助化疗预防转移复发的效果。方法 1995年1月至1997年12月同一手术组行肝癌根治性切除并有肿瘤巨大、多灶、包膜不完整、伴有血管侵犯等转移复发危险因素者308例,其中115例于术中经肝动脉和(或)门静脉放置DDS作为试验组,193例未置DDS作为对照组。试验组在术后4～6周经DDS行肝脏区域化疗栓塞,此后视情况隔2～4个月重复一次,对照组则不做对转移复发有影响的辅助治疗。结果 随访至2002年3月,1、3、5、7年累积转移复发率:试验组为5.8％、22.3％、28.6％和43.9％,明显低于对照组的16.8％、39.7％、59.64％和59.64％(P<0.001)。中位转移复发时间:试验组为30.6个月,明显长于对照组的20.9个月(P<0.001)。1、3、5、7年生存率:试验组为96.8％、91.3％、84.8％和77.7％,明显高于对照组的87.3％、73.8％、63.6％和5&7％(P<0.001)。结论 肝癌根治术后经DDS区域辅助栓塞化疗既推迟了转移复发时间又降低了转移复发率。Objective To analyze the efficacy of hepatic regional chemoembolization (HRCE) via implanted drug delivery system (DDS) in the prevention of metastasis and recurrence after radical resection of primary liver cancer (PLC). Methods From January 1995 to December 1997, 308 patients with PLC were surgically treated in our institute. Amongst these patients, 115 received postoperative HRCE via DDS (group A) and the other 193 did not undergo it (group B). Results The follow-up study in all the patients showed that the 1- 3-, 5- and 7-year rates of metastasis and recurrence were significantly lower in group A than in group B (5. 8%, 22. 3%,28. 6% and 43. 9% vs 16. 8%, 39. 7%, 59. 64% and 59. 64%, P<0. 001). Meanwhile, the 1-, 3-, 5- and 7-year survival rates wee markedly higher in group A than in group B (96.8%, 91.3%, 84.8% and 77.7% vs 87.3%, 73. 8%, 63. 6% and 58. 7%, P<0. 001). The mean time of metastasis and recurrence was longer in group A than in group B (30. 6 months vs 20. 9 months). Conclusions HRCE via DDS after radical resection of PLC is an effective means for prevention of postoperative metastasis and recurrence.

关 键 词：肝癌 根治性切除术 术后 区域辅助化疗 预防 肿瘤转移 肿瘤复发 

分 类 号：R735.7[医药卫生—肿瘤] R730.53[医药卫生—临床医学]