肝癌破裂后腹腔转移瘤的介入栓塞治疗

Transcatheter Arterial Chemoembolization in the Treatment of Celiac Metastasis after Hepatocellular Carcinoma Rupture

目的:探讨经导管化疗栓塞术(transcatheter arterial chemoembolization,TACE)对肝癌破裂后腹腔转移瘤的治疗价值。方法:对31例肝癌破裂后腹腔转移的患者进行TACE治疗,分析治疗效果、不良反应和中位生存期等。结果:患者在TACE术后均出现不同形式和不同程度的不良反应,但按照美国国立癌症研究所制定的常规毒性判定标准3.0版(common terminology criteria for adverse events v3.0,CTCAE v3.0)评价,均未出现Ⅳ级不良反应。TACE总有效率为74.2%。第一次TA-CE治疗至研究终点的中位生存期为10个月。结论:TACE治疗肝癌破裂后腹腔转移瘤是安全有效的。在TACE术中,仔细寻找肿瘤供血动脉并应用超选择插管技术对肿瘤病灶进行化疗栓塞是提高TACE治疗效果、减轻栓塞不良反应的关键。

Objective：To assess the efficacy of transcatheter arterial chemoembolization（TACE） in the treatment of celiac me- tastasis alter the rupture of hepatocellular carcinoma（HCC）. Methods： A total of 31 patients with celiac metastasis after HCC rupture underwent TACE. The curative effects, adverse reactions and the median survival time have been analyzed. Results： The total effective rate was 74.2%. The median survival time was 10 months. The most common adverse events were abdomi- nal pain and fever, but no adverse event has been observed as serious as grade 4 by CTCAE v3.0 （common terminology criteria for adverse events v3.0）. Conclusions： TACE is a safe and effective way to treat celiac metastasis after HCC rupture.