放射性^(125)I粒子植入联合TACE治疗原发性肝癌合并门脉癌栓

Radioactive Lodine 125 Seeds Implantation Combined with TACE for Treatment of Primary Hepatocellular Carcinoma with Portal vein Tumor Thrombus

目的评价放射性125I粒子联合肝动脉化疗栓塞(TACE)治疗原发性肝癌(PHC)合并门静脉癌栓(PVTT)的临床价值。方法回顾性分析32例PHC合并PVTT患者行放射性125I粒子植入联合TACE治疗的有效率、疾病控制率、平均生存期、1年及2年生存率,并观察治疗前后癌栓大小的变化。结果完全缓解5例、部分缓解19例、稳定5例、进展3例,患者总有效率为75.00%,疾病控制率为87.50%,平均生存期为(15.89±1.81)个月,1年生存率和2年生存率分别为(49.6±10.2)%和(25.5±10.2)%。结论放射性125I粒子联合TACE治疗原发性癌合并门静脉癌栓疗效确切,可控制病变进展,延长患者生存期。

Objective To evaluate the clinical effect of radioactive Iodine 125 seeds implantation combined with TACE for treatment of primary hepatocellular carcinoma with portal vein tumor thrombus. Methods 32 cases of primary hepato- cellular carcinoma with portal vein tumor thrombus were retrospectively analyed. All the intrahepatic primary tumors were treated by TACE firstly, then portal vein tumor thrombus were treated by CT guided percutaneous radioactive Iodine 125 seeds implanted. The change of tumor thrombus after treatment were observed and the treatment efficiency, disease control rate, median survival, 1 - year and 2 - year survival rate were analyzed in order to explore the efficacy Resnlts After treatment, complete remission （CR） was in 5 cases, partial remission（PR） was in 19 cases, stable disease （SD） wasin 5 case and progressive disease （PD） was in 3 cases. Total effective rate was 75.00% of all patients and the disease control rate was 87.50%, with an average survival period of 15.89 ± 1.81 months. 1 - year and 2 - year survival rates were （49.6 ± 10.2） % and （25.5 ±10.2 ） %. Conclusion Radioactive Iodine 125 seeds implantation combined with TACE for the treatment of primary hepatocellular carcinoma with portal vein tumor thrombus could control the disease progression and prolong survival.