经DDS泵门静脉化疗联合肝动脉插管化疗栓塞在肝癌合并门静脉癌栓术后治疗中的作用

目的探讨经DDS泵门静脉化疗(PVC)联合肝动脉插管化疗栓塞(TACE)预防术后肝细胞肝癌和门静脉癌栓复发的价值。方法将2006年1月至2008年1月我院收治的97例有手术指征的肝癌合并门静脉癌栓的患者随机分成3组,切除肿瘤并取癌栓后A组行TACE、B组行经DDS泵PVC,C组行经DDS泵PVC联合TACE。随访三组患者术后6月、1年、2年无瘤生存率及累积生存率,并作统计学分析。结果术后6月、1年、2年无瘤生存率及累计生存率C组均高于A组,B组。术后6月、1年无明显差异;术后2年具明显差异。结论对肝细胞肝癌合并门静脉癌栓的患者而言,手术切除肿瘤并取癌栓后行经DDS泵PVC联合TACE较单行经DDS泵PVC或TACE可有效提高其远期无瘤生存率及累计生存率。

Objective To approach the contribution of chemotherapy of TACE（Transcatheter Arterial Chemoembolization） associated PVC（portal vein chemotherapy） per-DDS（Drug Delivery System） to prevent the recurrence of hepatic cell cancer（HCC） and portal vein tumor thrombus（PVTT）.Methods We treated 97 cases with HCC and PVTT from January 2006 to January 2008,resceted the tumor and tumor thrombus of all cases,random divided them into 3 groups.Give the TACE only to group A,PVC per-DDS only to group B,TACE and PVC per-DDS to group C.Follow-up visit and contrast the disease free survivals（DFS） and accumulative survival rates between the 3 groups at 6 months,1year and 2 years after the operation.Results The contrast the DFSs and accumulative survival rates of group C all exceeds group A ＇s and group B ＇s at 6 months,1year and 2 years after the operation.There is difference with significance only at 2 years after the operation.Conclusion For the patients with HCC and PVTT,the chemotherapy of TACE associated PVC per-DDS can elevate their forward DFSs and accumulative survival rates campared with the TACE only or PVC per-DDS only after resceted the tumor and tumor thrombus.