减量化疗肝动脉栓塞治疗肝癌合并腹水的研究

Dose-reduced transarterial chemoembolization for primary liver cancer patients with ascites

目的研究减量化疗肝动脉栓塞治疗伴有中等量以上腹水原发性肝癌的安全性及疗效。方法回顾性分析44例经减量化疗肝动脉栓塞治疗的伴有腹水的原发性肝癌病例,腹水均在中等量以上。结果 44例患者中位生存期为11.0月,1、2、3年生存率分别为48.8%、34.0%、34.0%。白蛋白≤35 g/L是影响总体生存率的独立危险因素(r=0.090,P=0.001)。有23例(52.3%)患者术后1月随访腹水较术前消失或明显减少,21例(47.7%)与术前相当。44例术后无肝功能衰竭、消化道出血等严重并发症发生。结论减量化疗肝动脉栓塞治疗伴有中等量以上腹水的原发性肝癌是安全有效的。

Objective To evaluate the efficacy and safety of dose-reduced transarterial chemoembolization for primary liver cancer patients with medium or massive ascites. Methods The clinical data of 44 patients with medium or massive ascites who underwent dose-reduced transarterial chemoembolization were retrospectively analyzed. Results The overall median survival time of 44 patients was 11.0 months. The 1-, 2-, 3-year cumulative survival rates were 48.8%, 34. 0% and 34.0% , respectively. Serum albumin level ≤ 35 g/L was an independent risk factor for survival（ r = 0. 090, P =0. 001 ）. Ascites disappeared or significantly reduced 1 month after treatment in 23 （52. 3% ） patients, and remained the same in 21 （47.7%） patients. No severe complications like gastrointestinal bleeding or liver failure occurred. Conclusions Dose-reduced transarterial ehemoembolization is safe and effective for primary liver cancer patients with medium or massive ascites.