肝动脉化疗、栓塞治疗原发性肝癌的临床研究（附188例分析）

Hepatic Arterial Infusion Chemotherapy and Embolization in the Treatment of Primary Hepatic Carcinoma: Clinical Studies of 188 Cases

目的：研究原发性肝癌肝动脉化疗、栓塞的疗效及其影响因素。材料与方法：回顾性分析１８８例肝癌肝动脉化疗、栓塞的临床随访资料。结果：总疗效为症状缓解占５９．６％，肿瘤缩小占５５％，ＡＦＰ下降占３７．８％，半年及１、２、３年生存率分别为７５．４％、４６％、２３．５％、１４．７％，平均生存期１２．２月，最长已存活５０月，获二步手术切除１８例，对比分析了７个影响疗效的有关因素。结论：无或轻度肝硬化、早中期、单个肿瘤、直径＜１０ｃｍ、无门脉癌栓或肝动－静脉瘘、行栓塞治疗、治疗次数在３次以上者，其中远期疗效明显优于对应组。

Objective: Studying the effects and factors influencing effects of primary hepatic carcinoma (PHC) treated by HAI or HAE. Materials and Methods: Follow up informations in 188 patients with PHC treated by HAI or HAE were analyzed retrospectively.Results: The overall therapeutic effect was symptomatic relief in 59.6%, tumor shrinking in 55%, AFP decreasing in 37.8%, half, 1,2,3 year's survival rate being 75.4%, 46%, 23.5%, and 14.7% respectively. The mean survival time was 12.2 months and the longest survival period was 50 months. 18 patients gained chance to secondly surgical resection. Seven factors influencing effect were analyzed.Conclusion: It revealed that: Those of no or mild cirrhosis, early or moderate stage, single tumor, less than 10cm. in diameter, no cancerous emboli within portal vein or hepatic A V shunt, embolitherapy more than 3 times, had better and longer therapeutic efficacy than the contrast groups. Overcoming the influencing factors and comprehensive therapy would improve the effect of HAI or HAE therapy of PHC.