门静脉灌注化学治疗药物治疗肝癌伴门静脉癌栓的临床价值

Intraportal chemotherapy for hepatocellular carcinoma patients with tumor thrombosis of the portal vein

目的探讨肝细胞肝癌伴门静脉癌栓 (portalveintumorthrombi,PVTT)外科手术后 ,门静脉灌注化学药物治疗的价值。方法本组 45例伴门静脉主干或Ⅰ级分支癌栓的肝癌患者 ,在行手术切除后随机分为两组 ,一组行肝动脉化疗 ,同时行门静脉置泵灌注化疗 (治疗组 ) ,另一组行肝动脉化疗 (对照组 )。结果治疗组 6个月、12个月、18个月的生存率分别为 86 % (18例 )、76 % (16例 )、48% (10例 ) ;对照组为 75 % (18例 )、5 8% (14例 )、33% (8例 )。两组比较差异均有显著意义 (P <0 0 5 )。结论肝癌伴PVTT手术切除术后 ,为防治门静脉癌栓导致肝内转移、复发 ,术中除应尽量取净癌栓组织外 。

ObjectiveTo evaluate portal vein chemotherapy for the treatment of hepatocellular carcinoma with portal vein tumor thrombi(PVTT).MethodsFourty five HCC patients with tumor thrombi in the main portal vein or the first branches undergoing surgical resection were divided into two groups receiving postoperative intraarterial and intraportal chemotherapy (21 cases), and intraarterial chemotherapy only (24 cases).ResultsThe survival rates of 6,12,18 months was 86%, 76% and 48% in the treatment group compared with 75%, 58% and 33% in the control group respectively. There were significant difference between the two groups.Conclusion Hepatectomy for HCC with removal of tumor thrombi and transcatheter hepatic arterial and portal vein chemotherapy is an effective treatment for HCC with PVTT.