肝切除联合改良FOLFOX方案治疗肝癌合并门静脉癌栓的临床观察

Hepatectomy combined with modified FOLFOX regimen for hepatocellular carcinoma patients with portal vein tumor thrombosis

目的探讨手术联合改良FOLFOX方案治疗肝癌合并门静脉癌栓的临床价值。方法 5例肝细胞癌（HCC）合并门静脉癌栓患者行肝切除联合门静脉取栓术,术后采用改良FOLFOX方案进行化疗。结果术后随访3~27个月,2例死亡,3例存活患者无转移复发。术后生存时间3~27个月,平均生存18.2个月。术后2例出现腹水,1例反应性胸水,经治疗后痊愈。化疗过程中出现3例恶心呕吐,2例神经感觉异常,2例白细胞减少,均可耐受。结论对HCC合并门静脉癌栓患者,肝切除联合门静脉取栓辅以改良FOLFOX方案化疗是一种有效的综合疗法。

Objective To evaluate modified FOLFOX regimen combined with hepatectomy with removal of tumor ernbolus for hepatoeellular carcinoma with portal vein tumor thrombosis. Methods Hepatectomy and tumor embolus removal or embolectomy through the portal vein was done in 5 hepatoeellular carcinoma patients with portal vein tumor thrombosis. Five patients received modi- fied FOLFOX regimen after operation. Results During 3-27 months follow-up, 2 patients died and the remaining 3 patients survived without recurrence and metastasis. The average survival time of 5 patients was 18.2 months（range 3-27 months） after the operation. After the operation, 2 patients occured ascites, and one patient got reaction hydrothroax. During chemotherapy, there were 3 cases of nausa and vomiting, 2 cases of neurotoxicity and 2 cases of leukopenia, which were tolerable. Conclusion Modified FOLFOX regimen combined with hepatectomy and tumor embolus removal or embolectomy is an effective therapy for hepatoeellular carcinoma with portal vein tumor thrombosis.