肝动脉置管化疗栓塞治疗不可切除胆管细胞型肝癌的疗效观察

Effect of hepatic arterial cathetering chemoembolization in the treatment of unresectable intrahepatic cholangiocarcinoma

目的 :评估肝动脉置管化疗栓塞术治疗不可切除胆管细胞型肝癌的疗效。方法 :回顾性分析我院2012年6月—2014年12月诊断为胆管细胞型肝癌并接受肝动脉置管化疗栓塞术或肝动脉灌注化疗栓塞术的73例患者的临床资料,比较各组之间的疗效、客观缓解率、临床获益率、不良反应及生存期。结果:肝动脉置管化疗栓塞组完全缓解(CR)5例,部分缓解(PR)15例,疾病稳定(SD)9例,疾病进展(PD)5例,客观缓解率58.8%,临床获益率85.3%;肝动脉灌注化疗栓塞组CR 3例,PR 12例,SD 10例,PD 14例,客观缓解率38.5%,临床获益率64.1%。两组患者临床获益率间差异有统计学意义(P<0.05)。两组患者不良反应间的差异无统计学意义(P>0.05)。两组患者中位生存时间分别为19.04月和13.03月,经Log-rank检验,差异有统计学意义(P<0.05)。结论:肝动脉置管化疗栓塞术对不可切除胆管细胞型肝癌有一定的疗效,其临床获益率、生存时间较单纯的肝动脉灌注化疗栓塞有优势。

Objective： To investigate the effect of hepatic arterial cathetering chemoembolization on patients with unresectable intrahepatic cholangiocarcinoma. Methods： The clinical data of 73 patients with unresectable intrahepatic cholangiocarcinoma from June 2012 to December 2014 were retrospectively analyzed. The patients were treated with hepatic artery cathetering chemoembolization or hepatic artery perfusion chemoembolization. The curative effect, objective response rate, clinical benefit rate, survival time and adverse reaction were compared between two groups. Results： In hepatic artery cathetering chemoembolization group, complete response（CR） was 5 cases, partial response（PR） was 15 cases, stable disease（SD） was 9 cases, and progressive disease（PD） was 5 cases, the objective response rate was 58.8% and clinical benefit rate was 85.3%. In hepatic artery perfusion chemoembolization group, CR was 3 cases, PR was 12 cases, SD was 10 cases, and PD was 14 cases, the objective response rate was 38.5% and clinical benefit rate was 64.1%. There was significant difference of clinical benefit rate between the two groups（P〈0.05）. There was no significant difference in adverse reaction between the two groups（P〉0.05）. The median survival time was 19.04 months and 13.03 months respectively, and the difference was statistically significant between the groups（P〈0.05）. Conclusion： Patients with unresectable intrahepatic cholangiocarcinoma can benefit from hepatic artery cathetering chemoembolization, especially in the clinical benefit rate and survival time.