摘要
目的比较门静脉支架及经动脉药物治疗栓塞（TACE）联合或未联合血管内植入碘-125（^125I）粒子条治疗原发性肝癌伴门静脉主干癌栓的疗效。方法对106例（男94例，女12例，平均年龄53．23岁）在我院接受TACE治疗的原发陛肝癌合并门静脉主干癌栓患者的资料进行回顾性分析，其中56例（A组）在门静脉内植入支架及^125I粒子条，余50例（B组）仅在门静脉内植入支架。分别对两组患者的生存期、支架通畅率及相关不良事件进行分析。对治疗前后各测量值的改变采用配对样本t检验，计数资料采用x^2检验，用Kaplan-Meier法分析生存时间及支架通畅期。结果门静脉内植入支架及^125I粒子条的技术成功率为100％，无严重相关不良事件发生。两组患者中位生存期分别为335d（A组）及146d（B组），P=0．001（P〈0．05）及HR=2．244；两组患者支架的中位通畅期分别为400d（A组）及190d（B组），P=0．005（P〈0．05）及HR=2．479。结论门静脉支架及TACE联合血管内植入^125I粒子条能显著延长原发陛肝癌伴门静脉主干癌栓患者的生存期。
Objective To compare the efficacies of portal vein stenting and transcatheter arterial chemoembolization （TACE） combined therapy performed with or without endovascular implantation of iodine-125 （125I） seeds strand in patients with hepatocellular carcinoma （HCC） and main portal vein tumor thrombus （MPVTT）. Methods One-hundred-and-six patients with HCC complicated by MPVTT who were treated with portal vein stents and TACE, either with （Group A, n = 56） or without （Group B, n = 50） endovascular implantation of J251 seeds strand, between July 2005 and April 201 I, were retrospectively analyzed. Overall survival, stent patency, and procedure-related adverse events were compared between the two groups. Results The technical success rate was 100% for placement of 125I seeds strands and stents in the obstructed main portal vein. No serious procedure-related adverse events were recorded. Group A had significantly higher median survival （335 days vs. group B： 146 days; P = 0.001, hazard ratio （HR） = 2.244）. Additionally, group A had significantly higher median stent patency （400 days vs. group B： 190 days; P = 0.005, HR = 2.479）. Conclusion The combination therapeutic strategy of portal vein stenting and TACE with endovascular implantation of 125I seeds strands improves the survival of HCC patients with MPVTT complication.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2012年第12期915-919,共5页
Chinese Journal of Hepatology
关键词
癌
肝细胞
门静脉
癌栓
支架
碘-125粒子条
经动脉药物
治疗栓塞
Carcinoma, hepatocellular
Portal vein
Tumor thrombus
Stent
125I seeds strand
Transcatheter arterial chemoembolization
