期刊文献+

减量肝动脉化疗栓塞治疗伴有门脉癌栓的原发性肝癌的安全性和疗效 被引量:9

Feasibility and Efficacy of Dose-reduced Transcatheter Arterial Chemoembolization (TACE) for Primary Liver Cancer Patients with Portal Vein Thrombosis
下载PDF
导出
摘要 目的:研究减量肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)对伴有门脉癌栓肝癌治疗的安全性和疗效。方法:分析复旦大学附属中山医院肝癌研究所行减量TACE治疗伴门脉主干(含一级分支)癌栓的37例原发性肝癌的临床资料。Child A级34例,B级3例。37例共行TACE 75次。结果:37例患者的中位生存期为11.67个月。6个月、12个月和18个月的生存率为75.01%、41.03%和17.61%。门脉癌栓内碘油沉积良好组14例,沉积不良组23例。碘油沉积良好组的中位生存期显著优于沉积不良组为(16.23个月与6.80个月,P<0.05)。碘油沉积良好组的6个月、12个月和18个月的生存率显著高于沉积不良组(分别为100%、63.49%、31.75%和60.29%、13.03%、0%,P<0.05)。多因素分析提示门脉癌栓内碘油沉积情况是唯一的预后因素。Cox回归系数1.67,RR 5.31。术后发生上消化道出血1例,肝功能衰竭症1例, (治疗后2周内死亡),2例治疗后肝功能Child分级增加。结论:减量TACE治疗伴门脉主干癌栓的肝癌是安全有效的。门脉癌栓内碘油沉积良好提示预后好。 Objective:To evaluate the efficacy and safety of does-reduced transcatheter arterial chemoembolization (TACE) for primary liver cancer patients with major portal vein thrombosis. Methods: 37 patients with major portal vein and/or its first branch thrombosis underwent does-reduced TACE were retrospectively analyzed. The Child's scale were A for 34 patients and B for 3. Results: 14 patients achieved good precipitation of lipiodol in the portal vein thrombosis, the other 23 patients with poor precipitation of lipiodol in the portal vein thrombosis. The overall median survival time was 11.67 months. The cumulative survival rates were 75.01% (6 months), 41.03% (12 months), and 17.61 % (18 months). There werel4 patients achieved well precipitation of lipiodol in the portal vein thrombosis and the other 23 with poor lipiodol precipitation. For patients with well precipitation of lipiodol, the median survival time was significantly longer than patients with poor lipiodol precipitation (16.23 VS 6.80 months, P〈0.05). The 6m, 12m and 18m survival rate of patients with well lipiodol precipitation was significantly better than that of with poor lipiodol precipitation (100 %、 63.49 %. 31.75/% VS 60.29 %. 13.03 %. 0/%, P〈0.05). Cox multivariable analysis shows that the extent of lipiodol precipitation was the only significant predicting factor for efficacy of therapy (Cox regressive coefficientl. 67, RR5.31). All the patients were safely tolerated with dose-reduced chemoembolization except 1 died of liver failure 2 weeks after the procedure, 1 case of upper gastrointestinalt bleeding,the other 2 with increased Childpugh scale. Conclusion:Dose-reduced chemoembolization for primary liver cancer patients with major portal vein thrombosis is safe, and can partially achieve curative effect especially for patients with good precipitation of lipiodol in the portal vein thrombosis.
出处 《中国临床医学》 北大核心 2007年第2期180-182,共3页 Chinese Journal of Clinical Medicine
关键词 原发性肝癌 肝动脉灌注化疗栓塞术 门脉癌栓 Primary liver cancer (PLC) Portal vein thrombosis (PVTT) Transcatheter arterial chemoembolization (TACE)
  • 相关文献

参考文献6

  • 1Cedrone A,Rapaccini GL,Pompili M,et al.Portal vein thrombosis complicating hepatocellular carcinoma.Value of ultrasound-guided fine-needle biopsy of the thrombus in the therapeutic management[J].Liver,1996,16:94-98.
  • 2Arii S,Tanaka J,Yamazoe Y,et al.Predictive factors for intrahepatic recurrence of hepatocellular carcinoma after partial hepatectomy[J].Cancer,1992,69:913-919.
  • 3Ando E,Yamashita F,Tanaka M,et al.A novel chemotherapy for advanced hepatocellular carcinoma with tumor thrombosis of the main trunk of the portal vein[J].Cancer,1997,79:1890-1896.
  • 4杨秉辉,夏景林.原发性肝癌的临床诊断与分期标准[J].中华肝脏病杂志,2001,9(6):324-324. 被引量:1014
  • 5Pirisi M,Avellini C,Fabris C,et al.Portal vein thrombosis in hepaticellular carcinoma:age and sex distribution in an autopsy study[J].J Cancer Clin Oncol,1998,124:397-400.
  • 6姚平.结肠癌肝转移的血管造影及其化疗栓塞疗效观察[J].中国临床医学,2002,9(5):525-527. 被引量:1

二级参考文献3

共引文献1013

同被引文献76

引证文献9

二级引证文献20

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部