结节型肝癌综合介入治疗的临床疗效分析

The Clinical Study of Nodular HCCs Treated by Combined Interventional Treatment

目的 评价综合应用节段性肝动脉化疗栓塞(STACE)和无水乙醇注射术(PEI)与单独应用STACE治疗结节型肝癌的临床疗效。资料与方法 临床诊断为结节型肝癌5 6例,共有瘤体6 6个,肿块直径2 .2～5 .0cm ,平均4 .1cm。随机分成STACE治疗组2 6例,STACE +PEI治疗组30例。观察两组病例的临床疗效,比较其1、2、3年累计复发率和生存率。结果 STACE组1、2、3年的累计复发率和生存率分别是15 .4 %、34.6 %、4 2 .3%和96 .2 %、80 .1%、6 5 .4 %。STACE +PEI组1、2、3年累计复发率和生存率分别是3.3%、10 .0 %、16 .7%和96 .7%、83.3%、76 .7%。两组比较:联合治疗组第2、3年复发率显著低于单独STACE组,而其平均治疗次数少于单独STACE组。结论 与单独应用STACE比较,联合应用STACE +PEI治疗结节型肝癌可降低患者的复发率,减少患者的重复治疗次数,是安全和更有效的治疗结节型肝癌的方法。

Objective To investigate the clinical effect for treating nodular HCCs both by combined subsegment transcatheter arterial chemoembolization and percutaneous ethanol injection (STACE+PEI) and by only STACE.Materials and Methods 56 patients with nodular HCCs had 66 masses, the diameter of the masses were from 2.2cm to 5.0cm, the mean diameter was 4.1cm. The patients were divided into two groups: STACE group (26 cases) and STACE+PEI group (30 cases). The clinical effect and 1-, 2- and 3 year cumulative recurrence rates and survival rates of HCC were observed and compared. Results In STACE group 1-, 2- and 3 year cumulative recurrence rates and survival rates were 15.4%, 34.6%, 42.3% and 96.2%, 80.1%, 65.4%. The related numbers in STACE and PEI group were 3.3%, 10.0%, 16.7% and 96.7%, 83.1%, 76.7%. The 2-, 3-year cumulative recurrence rates of STACE+PEI group were significantly lower than that of STACE group (P< 0.05) as well as the mean treatment times less than that of STACE group.Conclusion Comparing with the STACE for nodular HCCs, the combined STACE and PEI can reduce the recurrent rate and cut down the repeated treatment times. STACE+PEI is a safe and more effective method for treatment the nodular HCCs.