90例无法手术切除的结肠癌肝转移病例的介入治疗分析

Analysis of Interventional Treatment for 90 Cases Colorectal Cancer with Liver Metastasis Could not be Surgically Removed

目的探讨90例结肠癌肝转移的临床治疗,以期寻找结肠癌肝转移的适宜治疗方法。方法选取2010—2012年广西医科大学附属肿瘤医院发生结肠癌肝转移无法手术切除的90例患者为研究对象,根据治疗方法的不同将所选患者分为三组,A组经导管肝动脉化疗栓塞术(TACE)治疗,B组经导管肝动脉化疗栓塞术联合射频消融(TACE+RFA)治疗,C组经导管肝动脉化疗栓塞术(TACE)联合靶向治疗。所有患者随访3年,观察所选患者术后生存率及肝转移再发生率情况并比较。结果随访3年,对所选患者1、2、3年生存率情况进行比较,各组患者的生存率均明显下降,其中各组间两两比较结果显示,B组、C组术后3年生存率均高于A组,差异有统计学意义(P<0.05),B、C组之间比较,差异无统计学意义(P>0.05);术后第3年肝转移再发生率情况比较,B组与C组比较,差异无统计学意义(P>0.05);B组与A组比较、C组与A组比较肝转移再发生率均差异显著,差异有统计学意义(P<0.05)。结论结肠癌肝转移无法手术切除的患者,肝动脉介入联合射频消融治疗、联合靶向治疗疗效优于单纯肝动脉介入治疗,临床上应根据患者的具体情况采取适宜的治疗方法,提高患者的生存率,降低肝转移的再发生。

Objective To discuss the clinical therapy of 90 cases of hepatic metastasis of colonic carcinoma in order to look for a therapeutic. Methods To explore the clinical treatment of 90 cases of liver metastasis of colon cancer,in order to find the appropriate treatment of liver metastases of colon cancer. Results Having been follow-up visited for 3 years,the selected patients were compared with each other in terms of survival rate on year 1,2 and 3,each group of patients had a significantly lowered survival rate,wherein,it has been shown by the result of pairwise comparison that,the postoperative survival rate on year 3 of group B and C was clearly higher than that of group A,the difference between them was statistically significant（ P 〈0. 05）,the difference between group B and C was not statistically significant（ P 〉 0. 05）; in terms of postoperative recurrence rate of hepatic metastasis on year 3,the difference between group B and C was not statistically significant（ P 〉 0. 05）; the difference in recurrence rate of hepatic metastasis between group B and A and the counterpart between group C and A were all statistically significant（ P 〈 0. 05）. Conclusion As for the patients whose hepatic metastasis of colonic carcinoma cannot be removed by surgical resection,the hepatic arterial interventional therapy combined with radiofrequency ablation and with targeted therapy can achieve a better curative effect than hepatic arterial interventional therapy alone can do, clinically speaking,appropriate therapeutic methods may be taken according to the specific condition of patients,in order to improve the survival rate and reduce the recurrence of hepatic metastasis.