转移性肝癌的介入治疗

Intervention therapy of metastatic liver cancer

目的探讨转移性肝癌的介入治疗方法及疗效。方法收集我院2004年8月至2008年4月介入治疗的62例转移性肝癌,其中胃肠道肿瘤肝转移40例,肺癌肝转移10例,胰腺癌肝转移4例,鼻咽癌肝转移3例,胆总管癌肝转移3例,膀胱癌肝转移1例,前列腺癌肝转移1例。62例中,病灶为富血供27例,中等血供15例,乏血供20例,对于病灶为富血供、中等血供者进行肝动脉化疗栓塞;乏血供病灶进行置管持续灌注化疗,导管保留1周,间隔3～4周/次。介入治疗后,分析其临床症状体征及生存期。结果介入治疗后,所有患者临床症状体征不同程度地减轻,未发生与操作有关的严重并发症,通过随访,生存率0.5a96.8%,1a61.3%,2a41.9%,3a12.9%。结论对于不能手术的转移性肝癌依其不同血供选择合适的介入治疗方式,可达到较好的临床效果。

Objective To discuss the efficacy and modality of intervention therapy in patients with metastatic liver cancer（MLC）. Methods Sixty-two patients with MLC underwent the intervention therapy from August 2004 to April 2008 in our hospital, of whom, hepatic metastases originated from primary gastrointestinal（n=40）, pulmonary（n=10）, pancreatic（n=4）, nasopharyngeal（n=3）, choledocbous（n=3）, bladder（n=1）, and prostatic carcinoma（n=l）. According to the blood supply patterns of the metastatic lesions, all patients received different modalities of the intervention therapy, of whom, 27 patients with rich blood supply and 15 patients with middling blood supply underwent intrahepatic artery chemoembolization, while 20 patients with poor blood supply underwent transcatheter infusion chemotherapy. The catheters were inserted by using Sildinger technique and retained for a week with an interval of 3-4 weeks. After intervention therapy, the clinical manifestations and survival time were observed and analyzed for each case. Results The follow-up demonstrated that, the main symptoms and signs in all patients were relieved to different extent. There were no severe complications related to the procedure. The survival rate of the patients at 6, 12, 24 and 36 months after intervention therapy was 96.8 %, 61.3 %, 41.9 %, and 12.9 %, respectively. Conclusion Intervention therapy selecting proper modality based on the blood supply pattern of the metastatic lesions for unresectablc liver metastases may obtain more satisfactory efficacy.