88例中晚期原发性肝癌介入化疗栓塞治疗的临床分析

88 Cases of Advanced Primary Liver Cancer Chemotherapy Embolization for the Treatment of Clinical Analysis

目的:分析影响肝动脉介入化疗栓塞术(TACE)治疗原发性中晚期肝癌预后的主要因素,为治疗方案及预后的评估提供理论依据。方法:对88例单独使用TACE或TACE联合肝动脉介入化疗(TAI)、肝动脉介入栓塞(TAE)、经皮无水酒精注射(PEIT)等介入方法治疗中晚期肝癌的患者进行回顾性分析。观察近期疗效,计算总有效率和受益率;观察远期疗效,应用Kaplan—Meier法计算累积生存率,绘制生存曲线,对可能影响预后的因素行Cox回归分析。结果:总有效率CR+PR为21.59%。受益率CR+PR+SD为占93.18%。6、12、24、36个月生存率分别为:77.8%、61.6%、29.7%、21.2%。中位生存期为15个月。单因素Cox模型分析对预后影响有意义的因素有:门脉瘤栓、治疗方法、治疗次数。多因素分析显示门静脉癌栓、治疗次数为影响预后有统计学意义的因素。结论:门静脉癌栓和治疗次数是影响TACE治疗原发性中晚期肝癌预后的主要因素。以TACE为主的介入治疗可以延长中晚期肝癌患者的生存时间。

Objective Analysis of impact of hepatic artery infusion chemotherapy emh01ization（TACE） in the treatment of advanced primary liver cancer prognosis of the main factors for the treatment and prognosis of assessment and provide a theoretical basis. Method ：88 cases of TACE or TACE alone Joint hepatic artery infusion chemotherapy （TAI）, hepatic artery interventional embolization （ TAE ）, percutaneous ethanol injection （PEIT） intervention in the treatment- of patients with advanced hepatocellular carcinoma were analyzed retrospectively. Observation of efficacy and efficiency of the total benefit rate; observed long - term effect, the Kaplan - Meier method to calculate the cumulative survival rate, survival curves drawn on the possible impact of prognostic factors to Cox regression analysis. Results ：The total efficiency of CR ＋ PR for 21.59 percent. Benefit rate CR ＋ PR ＋ SD for accounting for 93.18 percent. 6,12,24,36 - month survival rates were ：77.8% ,61.6%, 29.7%and 21.2% o The median survival time was 15 months,Univariate Cox model analysis of prognostic impact of meaningful factors： portal vein tumor thrombus, the method of treatment, the number ot treatment. Multivariate analysis showed that the portal vein thrombosis, the number of treatment for a statistically significant prognostic factors, Conclusion：The portal vein tumor thrombus and number of treatments are the main factors of TACE treatment of primary advanced hepatocellular carcinoma prognosiso TACE mainly to the intervention therapy can be extended in the survival of patients with advanced hepatocellular carcinoma time.