中晚期肝癌508例的化疗栓塞疗效及影响因素分析

Analysis of therapeutic efficacy and survival factors of transcatheter arterial chemoembolization in 508 cases with advanced hepatocellular carcinoma

目的 :探讨中晚期肝癌化疗栓塞治疗的疗效及影响生存的因素。方法 :对 1990年 1月— 2 0 0 0年 10月间 5 0 8例中晚期肝癌行选择性肝动脉插管灌注化疗和 (或 )栓塞治疗共 2 0 2 5次 ,其中行选择性肝动脉插管灌注化疗栓塞治疗 44 8例 ,单纯灌注化疗 6 0例。结果 :选择性肝动脉插管灌注化疗栓塞一、二、三年生存率分别为 81.3%、38.6 %、2 1.6 % ;单纯灌注化疗一、二、三年生存率分别为 5 4.3%、2 1.3%、9.6 %。肿瘤分类、门静脉是否有癌栓、侧支循环的形成、碘油沉积情况以及栓塞技术是否得当是影响疗效的主要因素。结论 :选择性肝动脉插管灌注化疗栓塞可作为中晚期肝癌的常规治疗 ,远期疗效明显优于单纯灌注化疗。

Purpose:To evaluate the curative effect of transcatheter arterial chemoembolization(TACE) and other factors in the treatment of advanced liver cancer.Methods:From January 1990 to October 2000, 508 cases with unresectable advanced hepatocellular carcinoma (HCC) were given a total of 2 025 interventional treatments,448 cases were treated with TACE, while the remaining 60 cases were given transcatheter arterial infusion chemotherapy(TAI) alone.Results:The 1-,2-,and 3-year overall survival rate in the TACE group was 81.3%?38.6%?21.6% and in TAI group was 54.3%?21.3%?9.6%,respectively .The clinical type of the tumor,the portal vein tumor emboli,formation of tumorous collateral circulation,accumulation of iodized oil and the embolizing technique are the factors affecting curative effect.Conclusions:TACE could be routinely used for the treatment of advanced HCC, and long term results are better than TAI.