门脉支架同步125 I粒子条植入联合TACE治疗原发性肝癌合并门脉癌栓

The effect of intravenous stent synchronized with 125 I seed strips implantation combined with and transcatheter arterial chemoembolization on patients with primary hepatocellular carcinoma complicated with portal vein tumor thrombus

目的评价门脉支架同步125 I粒子条植入联合TACE治疗原发性肝癌合并门脉癌栓的疗效。方法回顾性分析27例原发性肝癌合并门脉癌栓的患者,行门脉支架同步125 I粒子条植入联合TACE治疗,观察患者生存时间并分析影响预后的因素。结果27例患者均成功植入支架,每例患者植入8~30枚粒子,平均(16.1±5.2)枚。27例患者共接受96次TACE,每例患者平均(3.6±2.0)次。全部患者平均生存时间12.4个月,中位生存时间8.0个月;3个月、6个月、12个月累积生存率分别为96.2%、74.1%、42.0%。此治疗方法联合靶向治疗对患者生存时间产生影响(P<0.05),程式分型Ⅲa型和Ⅲb型对生存时间影响无统计学意义(P>0.05)。结论门脉支架同步125 I粒子条植入联合TACE治疗对HCC合并PVTT患者带来了显著的生存获益,提高患者生存质量,且此治疗方法联合靶向治疗可延长患者生存时间,值得临床应用与推广。

Objective To evaluate the clinical value of intravenous stent synchronized with 125I seed strips implantation combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary hepatocellular carcinoma complicated with portal vein tumor thrombus.Methods 27 cases of primary hepatocellular carcinoma complicated with portal vein tumor thrombus were retrospectively analyzed.Intravenous stents and 125I seed strips were implanted with TACE therapy.The survival time and factors affecting prognosis were analyzed.Results A total of 27 portal vein stents were implanted and 8~30 particles per person,with an average of(16.1±5.2)particles.A total of 96 times in 27 patients received TACE treatment,with an average of(3.6±2.0)times.The mean survival time of patients was 12.4 months and the median survival time was 8 months.The cumulative survival rates of three months,six months and twelve months were 96.2%,74.1%and 42.0%,respectively.This treatment combined with targeted therapy affected survival time of patients(P<0.05).There is no significant difference affected survival time of patients between type III A and type III B(P>0.05).Conclusion Intravenous stent synchronize 125 I seed strips implantation combined with TACE in the treatment of primary hepatocellular carcinoma complicated with portal vein tumor thrombus has brought significant survival benefits and quality of life for patients,which is worthy of clinical application and promotion.This treatment combined with targeted therapy prolonged survival time of patients.