肝动脉化疗栓塞与单纯栓塞治疗原发性肝癌近期疗效的回顾性比较

Short-term Efficacy of TACE Versus TAE in Primary Hepatocellular Carcinoma

目的比较经皮肝动脉化疗栓塞（TACE）和经皮肝动脉栓塞（TAE）治疗原发性肝癌的近期疗效。方法搜集2015年1月至2017年1月广东省人民医院介入治疗科接受TACE和TAE治疗的202例中晚期肝癌患者,按照治疗方法分为TACE组106例,TAE组96例。在数字减影血管造影（DSA）下,TACE组行化疗栓塞（洛铂＋吡柔比星＋碘化油）,TAE组行单纯栓塞（Embosphere微球）,观察术后1个月两组患者肝脏目标病灶最长径总和的平均值、甲胎蛋白（AFP）及肝脏Child-Pugh分级,术后6个月肿瘤客观反应率（ORR）、疾病控制率（DCR）及血管介入次数。结果 TACE和TAE治疗前后目标病灶的变化及AFP差异无统计学意义（P〉0.05）,术后6个月两组ORR差异无统计学意义（P=0.08）,但TAE组DCR优于TACE组（P=0.01）,且介入次数明显小于TACE组（P〈0.01）。结论 TAE治疗原发性肝癌的近期疗效不劣于TACE,而且有效减少了介入栓塞的次数。

Objective To compare the short-term efficacy of transcatheter arterial chemoembolization（TACE） and transcatheter arterial embolization（TAE） in primary hepatocellular carcinoma.Methods From January 2015 to January2017,202 patients with advanced liver cancer who underwent TACE and TAE treatment in the interventional department of Guangdong Provincial People＇s Hospital were selected and divided into TACE group and TAE group according to treatment methods.Under digital contrast angiography（DSA）,TACE group received chemoembolization（Lobo plus Pirarubicin plus iodized oil）,and TAE group underwent embolization（Embosphere）.Liver targets were observed at 1 month after surgery in both groups.The sum of the longest diameter of lesions,AFP and liver Child-Pugh classification,6-month tumor objective response rate（ORR）,disease control rate（DCR）,and number of vascular interventions.Results There was no significant difference in changes of target lesions and AFP between TACE and TAE before and after treatment（P〉0.05）.There was no significant difference in ORR between the two groups at 6 months postoperatively（P = 0.08）.However,DCR in TAE group was better than TACE group（P〉0.05）.= 0.01）,and the number of interventions was significantly less than TACE group（P〈0.01）.Conclusion The short-term efficacy of TAE in the treatment of primary liver cancer is not inferior to TACE,and the number of interventional embolization is effectively reduced.