89例巨块型原发性肝癌介入化疗栓塞治疗体会

Transcather Arterial Chemoembolization for Huge Primary Liver Cancer:Report of 89 Cases

目的探索巨块型原发性肝癌介入栓塞治疗的疗效。方法89例巨块型原发性肝癌患者,经皮股动脉穿刺插管至肝动脉,化疗栓塞治疗肝癌;碘油用量为20～50ml。再注入明胶海绵颗粒栓塞治疗。发现肝外肿瘤供血动脉,超选择插管化疗栓塞后,注入适量明胶海绵栓塞治疗。结果本组病例中首次DSA造影发现11例存在肝外动脉供血;64例出现肝外供血动脉共计67支。术后甲胎球蛋白下降均>50%。术后4～6周复查CT,肿瘤最大直径缩小3.5～5.9cm。1、2、3年累计生存率分别为73.8%、48.3%和28.5%。结论巨块型原发性肝癌大剂量碘油栓塞联合肝外肿瘤供血动脉介入治疗,对于提高巨块型原发性肝癌的介入疗效具有重要意义。

Objective To study the healing effect of huge primary liver cancer with transcather arterial chemoemboliz - ation （TACE）. Methods Eighty - nine cases of diagnosed huge primary liver cancer were treated by TACE through trans -femoral -artery -catheter with 20 -50ml lipiodol and sufficient gelatin sponge. Super -selective catheterization and transcatheter dual arterial ehemoembolization to extraheptic arterial was preformed. Results Among all cases, eleven cases of extrahepatic arteries were found in the first Digital Subtraction Angiography; sixty - seven extrahepatic arteries to hepatic cancer were found in sixty - four cases. After 4 weeks to 6 weeks, CT showed 3.5 - 5.9 cm tumor regression after embolization. Serum AFP reduced over 50% was noted in all patients. The 1 - , 2 - , 3 - year sunTival rate of patients was 73.8 %, 48.3%, and 28.5% respectively. Conclusion High dose lipiodol TACE combined with interventional treatment of extrahepatic arteries have very important clinical significance for better efficacy of huge primary liver cancer patients.