肝动脉栓塞及经皮注射乙醇治疗肝癌的研究

Evaluation of Hepatic Chemoembolization and Percutaneous Ethanol Injection in the Treatment of HCC

目的 比较肝动脉灌注化疗及栓塞 (TACE)加经皮注射无水乙醇 (PEI)与单纯TACE治疗有包膜、单个、大病灶原发性肝癌的疗效。资料与方法 45例原发性肝癌患者随机分成A、B两组。A组 (n =2 3)在预先经导管TACE治疗后 ,在B超引导下行PEI治疗。B组 (n =2 2 )单纯TACE治疗。结果 TACE组肿瘤治疗的部分缓解率仅为 9% ,1、2、3年生存率分别为 5 9%、32 %和 0 % ;病灶完全坏死率为 0 % (0 /5 )。相比之下 ,TACE +PEI组肿瘤治疗的部分缓解率增加到 40 % (P <0 .0 5 ) ,1、2、3年生存率分别为 88%、5 6 %和 2 1% (P <0 .0 5 ) ;病灶完全坏死率为 6 7%(4 /6 )。结论 PEI+TACE对有包膜的单个大病灶肝癌的治疗是安全、有效的 ,对这一部分患者进行二期切除手术也是有好处的。

Objective To compare the therapeutic effectiveness of transcatheter arterial chemoembolization (TACE) plus percutaneous ethanol injectin (PEI) with simple TACE in the treatment of solitary, huge and encapsulated hepatocellular carcinoma (HCC).Materials and Methods Forty five patients with solitary, huge, encapsulated HCC were randomly divided into two groups. Group A included 23 patients, who were treated with TACE+PEI, while group B included 22 patients, who were treated with TACE alone. Results In group B, the partial remission rate was only 9%, the survival rate at 1, 2 and 3 years was 59%, 32% and 0%, respectively. The complete necrosis of the tumor was 0% (0/5). In group A, the partial remission rate was up to 40% (P<0.05), and the survival rate at 1, 2 and 3 years was 88%, 56% and 21% (P<0.05), respectively. The complete necrosis of the tumor was 67% (4/6).Conclusion The combined therapy of TACE with PEI is an effective and safe method for the treatment of solitary, huge and encapsulated HCC. It is also of value to the patients to receive secondary operation.