HCC伴PVTT经肝动脉-门静脉联合化疗栓塞疗效观察

Transcatheter arterial and intravenous chemoembolization in treatment of hepatocellular carcinoma with portal vein tumor thrombus

目的对原发性肝癌(HCC)伴门静脉癌栓(PVTT)的患者行肝动脉-门静脉联合化疗栓塞治疗后1年内的疗效进行观察。方法 选择符合纳入标准的HCC伴PVTT患者124例进行肝动脉-门静脉联合化疗栓塞治疗,观察治疗后在肿瘤及门脉癌栓变化、AFP变化、生存质量及生存率方面随访其1年内的疗效。结果 AFP变化,介入后转阴率为27.4%。治疗后肿瘤及门静脉癌栓变化,CR 6例(4.8%),PR 39例(31.5%),NC 45例(36.3%),PD 34例(27.4%)。治疗后1月、3月生存质量较前提高,两者比较差异有统计学意义(P<0.01),治疗后1年较前降低,两者比较差异有统计学意义(P<0.01)。生存率方面,治疗后1月、3月、6月和1年生存率分别100.0%、89.1%、71.6%和58.3%。结论 肝动脉-门静脉联合化疗栓塞治疗HCC伴PVTT患者改善生存质量、提高生存率方面均有较明显的短期疗效。

Objective To evaluate the therapeutic effect of transcatheter arterial and intravenous chemoembolization in treatment of bepatocellular carcinoma （HCC） with portal vein tumor thrombus （PVTT）. Methods One hundred and twenty four HCC patients with PVTY were treated with transcatheter arterial and intravenous chemoembolization. Patients were followed up for one year and the therapeutic effect and the quality of life were observed. Results On change of AFP, the changing negative rate after the therapy is 27.4% for changes of PVTY, 6 patients got CR （4.8%）,39 patients PR （31.5%）,45 patients NC（36.3% ）and 34 patients PD （27.4%）. The scores of QOL scale were raised 1 and 3 month after treatment compared to those before treatment （ P 〈 0.01 ） ; however QOL scores decreased ly after treatment （ P 〈 0.01 ）. The 1-, 3- and 6- month survival rates and ly-survival rate after transcatheter arterial and intravenous chemoembolization were 100.0%, 89.1%, 71.6% and 58.3%, respectively. Condusion Transcatheter arterial and intravenous chemoembolization has short-term effect in controlling tumor size and portal vein tumor thrombus, improving quality of life and raising survival rate of HCC patients with PVTT.