肝动脉化疗栓塞术治疗中晚期原发性肝癌的疗效观察

An observation of the curative effect of transcatheter arterial chemoembolization in patients with unresectable hepatocellular carcinoma

[目的]研究经导管肝动脉化疗栓塞术（TACE）治疗中晚期原发性肝癌的疗效并预测影响患者生存率的相关因素.[方法]80例中晚期原发性肝癌患者经1次或多次TACE治疗后,分别于治疗后第1、3、6、12个月对患者进行CT扫描评估肿瘤对治疗的反应并计算生存率.[结果]对所有患者随访观察3年（或者观察至死亡）,80例患者共进行了163次TACE,按Child-pugh分级A级48例（60.0％）,B级32例（40.0％）;肿瘤大小＜5cm 18例（22.5％）,5～10cm 42例（52.5％）,＞10cm 20例（25.0％）;行1、2、3、4次TACE的患者分别为12、56、9、3例;1、2、3年的总生存率分别为71.3％、43.8％和17.5％,肿瘤直径＜5cm患者TACE后3年生存率显著高于肿瘤直径为5～≥10crn患者.[结论]TACE是治疗中晚期肝癌的一种有效的方法,能有效缓解患者的临床症状并延长生存期,初始肿瘤的大小是决定患者生存率的独立影响因素.

[Objective] To investigate the outcome following transcatheter arterial chemoembolization （TACE）and to identify the predictors of survival in patients with unresetable hepatocellular carcinoma （HCC）. [Methods] Eighty HCC patients get clinical,biochemical and radiological examination befrom TA- CE. TACE was performed in those who fulfilled the inclusion criterial follow-up assessment was done with CT scan of the liver at 1,3,6,and 12 months therapeutic effect tumor response and survival rate were estimated. Univariate analyses were done for determinations of survival. [Results]eighty patients were subjected to 163 sessions of TACE. The Child＇s classification was. A 48 patients （60%）and B 32 patients （40%）. Tumor size was≤Scm in 18 （22. 5%） patients,〉5-10 cm in 42（52.5%） patients,and 〉10 cm in 20 （25 %） patients. 12,56,9,3patients were subjected to 1,2,3,4 sessions of TACE respectively, Overall survival rate was 71.3% ,43.8% and 17.5% at 1,2 and 3 years,respectively. Tumor size energed as an important predictor of survival. Conclution： TACE offers a reasonable palliative therapy for HCC. Initial tumor size is an independent predictor of survival.