原发性肝癌肝移植后肿瘤复发的化疗栓塞治疗

Chemoembolization for recurrent hepatocellular carcinoma after liver transplantation

目的评价介入化疗栓塞在HCC肝移植后肿瘤复发治疗中的作用。方法12例原发性HCC肝移植后肿瘤复发、且失去外科治疗机会的患者接受1次或多次TACE治疗(平均每例2.28次)。通过治疗后的影像学资料判定治疗反应,并用Kaplan-Meier生存曲线计算患者生存率。结果12例中7例(58.3%)肿瘤体积缩小≥30%。然而,在随访期间有11例(91.3%)出现了肝内或肝外新发病灶。移植后1、2、3和4年生存率分别为83.3%、57.1%、47.6%和17.9%;复发后6、12和24个月生存率分别为66.7%,50%和31.3%。结论对于原发性HCC肝移植后肿瘤复发且失去外科切除机会的患者,介入化疗栓塞在一定程度上可以控制肿瘤生长。

Objective To evaluate the interventional chemoembolization in treating unresectable recurrent hepatocellular carcinoma （HCC） after liver transplantation. Methods Twelve patients with unresectable recurrent HCC underwent one or more cycles （mean 2.25 cycles） of transarterial chemoembolization （TACE） after liver transplantation. The results were evaluated by follow-up CT scans and were classified into four grades. The survival rate was calculated by using Kaplan-Meier survival curve. Results No severe complications developed during follow-up period. Of the total twelve patients, targeted tumor showed a reduction in size by 30% in 7 （58.3%） after TACE. However, intrahepatic recurrence or extrahepatic metastasis occurred in 11 patients （91.3%）. Conclusion Our data obtained from this study indicates that TACE treatment seems to produce an effective tumor response for targeted recurrent HCC after liver transplantation.