原发性肝癌根治术后多次TACE方案预防复发的临床研究

A Clinical Study of Repeated Transcatheter Arterial Chemoembolization to Prevent Tumor Recurrence after Radical Resection for Hepatocellular Carcinoma

目的探讨多次肝动脉化疗栓塞(TACE)预防原发性肝癌(HCC)术后复发的临床疗效。方法回顾性收集2008年1月至2009年7月间HCC根治术后患者68例,其中单纯手术治疗的患者40例(对照组)和术后接受三次预防性TACE的患者28例(研究组),研究组患者均于术后1～2月给予首次预防性TACE,此后每隔2～4个月重复一次,总共三次。全部病例在根治术后随访36～40个月,对比分析两组间1、2、3年的累计复发率。结果 HCC根治术后,对照组1、2、3年累计复发率分别为57.5%、65.0%、67.5%。研究组1、2、3年累计复发率分别为7.1%、25.0%、28.6%。统计学分析研究组1、2、3年复发率均明显低于对照组(P值均<0.05)。研究组所有患者TACE术后副反应较轻,未出现严重并发症。结论 HCC根治术后给予三次预防性TACE是安全有效的,可显著降低术后复发率,延长肝癌患者无瘤生存期。

Objective To explore the clinical efficacy of 3 times transcatheter arterial chemoembolization （TACE）in the prevention of tumor recurrence after hepatectomy. Methods 68 patients with hepatocellular carcinoma（HCC）who had undergone radical surgery between January 2008 and July 2009 were collected retrospectively.The patients were divided into two groups according receiving TACE or not：the control group （n=40）without receiving any TACE and the study group （n=28）with receiving 3 times prophylactic TACE after operation.The first TACE was performed via hepatic artery at 1-2 months after operation and repeated at every 2-4 months （a total of three times）for the study group. All cases were followed up for 36 to 40 months after surgery. The rates of cumulative recurrence between two groups was compared. Results The 1-, 2-and 3-year cumulative recurrent rates in control group were 57.5%、65.0%、67.5% respectively, while as were 7.1%、25.0%、28.6% in the study group,respectively. Statistical analysis showed that relapse rate was lower in the control group than in the study group in 1, 2, 3 years （all P0.05）. Liver function damage of all patients in the study group were minimal after TACE and had no serious complications occurred. Conclusion For hepatocellular carcinoma patients after hepatectomy, receiving 3 times preventative TACE is safe and effective to decrease the recurrence rates and extend disease-free survival interval.