TACE治疗不同年龄组原发性肝癌367例

Treatment of hepatocellular carcinoma patients of different ages by transcatheter arterial chemoembolization:An analysis of 367 cases

目的:探讨经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)对不同年龄组原发性肝癌(primary hepatocellular carcinoma,PHC)患者疗效是否存在差别.方法:对2006-01/2011-07收治的PHC患者367例行肝动脉化疗栓塞,并进行回顾性分析,其中青年组≤44岁(n=46),中年组45-59岁(n=172),老年组≥60岁(n=149),对不同年龄组生存率进行Kaplan-Meier模型分析和Log-rank检验.结果:367例原发性肝癌患者6mo,1-,2-,3-年的生存率分别是88.8%、65.6%、35.1%、15.8%,中位生存时间为18mo.不同年龄组原发性肝癌患者6mo,1-,2-,3-年生存率的差异有统计学意义(P<0.05).虽然肿瘤大小在3组之间没有明显的差别(P=0.076),但老年患者在原发性肝癌的早期接受肝动脉化疗栓塞治疗比例明显高于青年组(20.1%vs8.7%).结论:老年组的生存期优于中年组及青年组,而青年组最差.

AIM： To evaluate local therapeutic efficacy of transcatheter arterial chemoembolization （TACE） for primary hepatocellular carcinoma （PHC） in patients of different ages. METHODS： The clinical data for 367 PHC pa- tients treated by TACE were analyzed retrospec- tively. These patients were divided into three groups by age： young group （≤ 44 years, n = 46）, middle-aged group （45-59 years, n = 172）, old group （≥ 60 years, n = 149）. Kaplan-Meier model and log-rank test were used to analyze the survival rates of patients in different age groups.RESULTS： The survival rates at six months, 1, 2, and 3 years were 88.8%, 65.6%, 35.1%, and 15.8%, respectively. Median survival time was 18 months. There were significant differences in the survival rates among the three groups （all P 〈 0.05）. Although there was no significant dif- ference in tumor size among the three groups （P = 0.076）, the proportion of old patients who received TACE treatment in earlier stages of disease were higher than that of young patients （20.1% vs 8.7%）. CONCLUSION： The survival rate of old PHC patients is higher than young and middle-aged pa- tients, and young patients have worst survival rate.