肝动脉化疗栓塞治疗肝转移性平滑肌肉瘤的临床体会

Clinical evaluation of transcatheter arterial chemoembolization in the treatment of metastatic liver leiomyosarcoma

目的探讨经肝动脉化疗栓塞治疗肝脏转移性平滑肌肉瘤(MLL)的临床价值。方法对8例经穿刺活检及免疫组化证实的MLL行肝脏CT三期增强扫描及肝动脉灌注化疗栓塞,随访1～3年,依据动脉化疗栓塞前后肝内病灶强化程度、DSA表现及生存期评估疗效。结果单发转移瘤3例、多发5例。治疗后临床症评价,显效6例,有效2例;影像学疗效评价显效3例,有效4例,无效1例。1、2、3年生存率分别为7/8、4/8和3/8。结论肝动脉灌注化疗栓塞是一种安全有效治疗肝脏转移性平滑肌肉瘤的方法。

Objective To assess the clinical value of transeatheter arterial chemoembolization （TACE） for the treatment of metastatic liver leiomyosarcoma （MLL）. Methods CT triphasic scanning and TACE were performed in 8 patients with MLL, which was proved by fine-needle aspiration biopsy and immunohistochemieal study. A follow-up of 1 - 3 years was conducted. Based on the enhancement degree of the hepatic lesion and the DSA manifestations of the lesion, which were observed both before and after TACE, and also on the survival time, the therapeutic effectiveness was evaluated. Results Of the eight cases, single metastasis was seen in 3 and multiple metastasis in 5. Excellent result was obtained in 6 cases and good result in 2 cases. Based on the imaging findings, marked effect was seen in 3 cases, good effect in 4 cases and no improvement in one case. The survival rate at I, 2 and 3 years was 87.8%, 50.0% and 37.8% respectively. Conclusion TACE is a safe and effective treatment for MLL.