肝癌TAE后残癌灶治疗方法选择及疗效分析

The selection of treatment for the remmant focus of HCC post - TAE and the curative effect analysis

目的探讨肝部TAE后残癌灶的治疗方法,并比较TAE与TAE+PEI的疗效。方法 86例大肝癌分为TAE(54例)和TAE+PEI(32例)两组,两组患者的临床和影像学资料无显著差异(P>0.05)。介绍了两组病人治疗措施和选择方法。并分别计算其介入治疗后1～2个月RHCL体积改变和1～3年的生存率。结果 (1)TAE组54例患者治疗1～2月RHCL体积缩小>50％的有24.1％(13/54)和<50％是16.7％(9/54),无变化29.6％(16/54) 和增大27.7％(15/54);TAE+PEI组32例患者治疗1～2月RHCL的体积缩小>50％的有59.4％(19/32),<50％的有37.5％(12/32),无变化9.4％(3/32)和体积增大为0。两组RHCL治疗后缩小差异具有显著和非常显著意义(P<0.05～0.01)。(2)TAE组54例患者1～3年生存率分别为46.3％(25/54),18.5％(10/54)和0。TAE+PEI组32例1～3年生存率分别为68.8％(22/32),50％(16/32)和21.9％(7/32)。两组患者1～3年生存率有显著差异(P<0.05～0.01)。结论不能切除的大肝癌TAE后RHCL的TAE+PEI疗效较TAE好。除此之外,尚可采取其他综合治疗方法。

Objective To study the treatment of hepatocellular carcinoma (HCC) post - TAE and comparing TAE with TAE + PEI in curative effect. Methods 86 cases of large HCC were divded into two groups: TAEgroup (n = 54 cases) and TAE + PEI group (n = 32 cases) ; There were no significant difierence (P > 0.05) in the fmdings of clinical and imageology of the both groups. The selective methods of treatment schemes in the both groups were introduced. The size of remainders of hepatocellular carcinoma lesion post - TAE ( RHCL) and l to 3 - year survival rate of the both groups pa-tients were calculated individually . Results (1) The volumes of RHCL in the both groups with interventional therapy after 1 - 2 months were as follows: TAE group: shrinking> 50% was 24. 1% (13/54) and < 50% was16. 7% (9/54); no changing 29 . 6% (16/54) and increasing 27 . 7% (15/54) respectively. TAE + PEI group: shrinking > 50% wsa 59. 4% (19/32) and < 50% was 37. 5% (12/32); no changing 9. 4% (3/32) and increasing 0 respectively; therefore the RHCL volumes changing in the both groups had significant difference (P<0.05-0.01). (2) 1-3- year survival rates of the patients in the both groups are as follows: TAE group: 46. 3% (25/54), 18. 5 (10/54), and 0; TAE+PEI group: 68. 8% (22/32), 50% (16/32) and 21. 9% (7/32) respectively. The survival rates of the pa-tients in the both groups had significant difierence (P < 0. 05 - 0. 01) respectively. Conclusion The curative effect of TAE + PEI was better than TAE in the RHCL of large HCC post - TAE.