TACE治疗原发性肝癌的远期疗效分析

Analysis of long-term efficacy of transcatheter arterial chemoembolization for primary hepatocellcular carcinoma

目的探讨TACE治疗原发性肝癌的远期临床疗效。方法对2003年1月—2009年8月于北京大学深圳医院接受TACE治疗并长期随访的143例原发性肝癌患者的临床及随访资料进行回顾性分析。结果 143例患者1、3、5年生存率分别为60.15%、24.20%及12.43%,中位生存时间为17个月。不同TNM分期患者1、3、5年生存率的差异均有统计学意义(P均<0.05);中晚期(TNM分期Ⅲ、Ⅳ期)患者综合治疗的1、3年生存率高于单纯TACE治疗(P均<0.05)。98例接受单纯TACE治疗的患者中,32例治疗后肝功能Child-Pugh评分较前升高,其中接受不同次数(1次、2次、3次及以上)TACE治疗的患者中,治疗后Child-Pugh评分升高者所占比例差异无统计学意义(P=0.84)。结论 TA-CE是原发性肝癌尤其是中晚期原发性肝癌安全、有效的姑息治疗方法,配合多元化的综合治疗有助于获得更好的疗效。

Objective To evaluate the long-term efficacy of TACE in the treatment of primary hepatocellcular carcinoma（PHC）.Methods Long term follow up and clinical data of 143 PHC patients treated with TACE in Peking University Shenzhen Hospital from Jan 2003 to Aug 2009 were retrospectively analyzed.Results The 1,3 and 5-year survival rates of all the 143 patients were 60.15%,24.20% and 12.43%,respectively,and the median survival time was 17 months.The 1,3 and 5-year survival rates had significant difference among PHC patients of different TNM stages（all P0.05）.For intermediate-advanced stages（TNM Ⅲ and Ⅳ stages） PHC patients,the 1 and 3-year survival rates of multimodal treatment were higher than those of single TACE treatment（both P0.05）.Compared with pre-treatment Child-Pugh scores,the post-treatment Child-Pugh scores increased in 32 of 98 patients treated with single TACE,while no significant difference was found among different treat times（1,2 or ≥3 times,P=0.84）.Conclusion TACE is a safe and effective palliation for PHC,especially for patients with intermediate-advanced stage PHC.Multimodal treatment can lead to better outcomes.