内支架植入术联合伽玛刀治疗肝细胞癌导致下腔静脉瘤栓的疗效分析

Effectiveness of stent placement combined with gamma-knife radiotherapy in treating inferior vena cava tumor thrombus caused by hepatocellular carcinoma

目的回顾性比较分析单纯内支架植入术和内支架植入术联合伽玛刀治疗肝细胞癌导致下腔静脉瘤栓的疗效。方法对22例患者行下腔静脉支架植入术(A组),26例行下腔静脉支架植入术联合伽玛刀治疗(B组),术后定期行下腔静脉造影,了解下腔静脉通畅情况。结果本组无与内支架植入术和伽玛刀治疗相关的严重并发症发生。治疗后下腔静脉内径均有不同程度的扩大,A组下腔静脉内径增大(0.89±0.28)cm,B组内径增大(1.52±0.20)cm(P<0.05)。随访期至少达6个月,A组3、6个月下腔静脉通畅率分别为52.94%、11.76%,而B组3、6个月下腔静脉通畅率均为100%,两组差异有显著意义(P<0.005)。结论内支架植入术联合伽玛刀治疗肝细胞癌导致下腔静脉瘤栓是安全有效的。

Objective To compare retrospectively the effectiveness of stent placement and stent placement combined with gamma knife radiotherapy in inferior vena cava （IVC） tumor thrombus caused by hepatocellular carcinoma （HCC）. Methods Twenty two patients were treated with stent placement in the IVC （group A）, 26 were treated with stent placement combined with gamma knife radiotherapy in the IVC （group B）. The venography of IVC was regularly performed in order to know whether the IVC was obstructed or not. Results No serious complication related with stent placement or gamma knife radiotherapy happened. After the treatment, the internal diameter of the IVC increased in different degrees. The in ternal diameter of the IVC in group A increased by （0.89±0.28）cm, and that of group B increased by （1.53±0.20）cm （P〈0.05）. During the follow up period of at least 6 months, the patency in group A was 52.94% after 3 months, 11.76% after 6 months, and that was 100% in group B after 3 months and 6 months respectively （P〈0. 005）. Conclusion Stent placement combined with gamma-knife radiotherapy for the treatment of IVC tumor thrombus caused by HCC is safe and effective.