132例原发性肝癌灌注化疗及栓塞治疗疗效观察

Efficacy of transcatheter arterial infusion chemotherapy and transcatheter arterial embolization in 132 patients with primary hepatocellular carcinoma

目的 探讨影响肝动脉灌注化疗＋ 栓塞治疗疗效的因素。方法 １９９３ 年１ 月～１９９７年１０ 月，对１３２ 例不能切除的原发性肝癌行选择性插管灌注化疗及栓塞治疗５９７ 次，肝动脉灌注化疗＋ 栓塞者１２２ 例，单纯灌注化疗１０ 例。结果 １ ，２，３ 年生存率分别为８１．８ ％ 、３６ ．４％ 和１８．２ ％ ，疗效较治疗初期有显著提高。肿瘤分期、栓塞剂及其用量、侧支循环的形成以及肝动脉超选择性插管是影响疗效的主要因素。结论 合理施行的肝动脉栓塞化疗可作为晚期不能切除肝癌患者的常规治疗。

Objective To find out factors influencing efficacy of transcatheter arterial infusion chemotherapy (TAI) and transcatheter arterial embolization (TAE) for unresectable primary hepatocellular carcinoma.Methods From January 1993 to October 1997, 132 patients with unresectable primary hepatocellular carcinoma (HCC) received 597 intervention treatments. Of the 132 patients, 122 patients were given TAI plus TAE (92.4%), while the remaining 10 patients were given TAI alone (7.6%). Results The 1-, 2-, and 3- year overall survival rate was 81.8%, 36.4% and 18.2%, respectively. The clinical stage of the disease, the embolizing agents used and their dosage, formation of collateral circulation to the tumor and proper application of superselective hepatic arterial catheterization are factors affecting treatment efficacy. Conclusion Adequately performed TAI and TAE can be routinely used for the treatment of unresectable liver cancer.