夹心饼干栓塞法治疗巨块型肝癌的临床疗效观察

Clinical efficacy of sandwich transarterial chemoembolization in patients with massive hepatocellular carcinoma

目的探讨“夹心饼干栓塞法”治疗巨块型肝癌病人的临床疗效。方法回顾性分析2017年4月至2019年12月中国科学技术大学附属第一医院治疗的巨块型肝癌病人63例,根据治疗方法不同分为夹心饼干组(35例)和常规TACE组(28例),比较两组病人的近期疗效、不良反应及生存期。结果夹心饼干栓塞治疗的总有效率为77.1%(27/35),疾病控制率为94.3%(33/35)。常规TACE组治疗的总有效率为67.9%(19/28),疾病控制率为89.3%(25/28),两组比较均差异无统计学意义(P>0.05)。夹心饼干栓塞组发热及呕吐发生率较常规TACE组低(P<0.05)。腹痛及严重并发症和生存曲线,夹心饼干治疗组较常规TACE组差异无统计学意义(P=0.195)。结论采用“夹心饼干栓塞法”治疗巨块型肝癌可以达到较好的临床缓解率并有较好的安全性。

Objective To explore the clinical efficacy of sandwich transcather arterial chemoembolization(TACE)in the treatment of massive hepatocellular carcinoma.Methods Sixty-three patients with primary massive hepatocellular carcinoma in the First Affiliat⁃ed Hospital of University of Science and Technology of China from April 2017 to December 2019 were retrospective analyzed.These subjects were assigned into sandwich TACE group and conventional TACE group.The clinical curative effect,adverse reactions and survival length of two groups were compared.Results The overall response rate(ORR)and disease control rate(DCR)of sandwich TACE group were 77.1%(27/35)and 94.3%(33/35),respectively.The ORR and DCR of conventional TACE group were 89.3%(25/28)and 89.3%(25/28),respectively.There were no significant differences in ORR and DCR between two groups(P>0.05).The incidence of fever and vomiting in the sandwich TACE group was significantly lower than that of the conventional TACE group(P<0.05).There were no significant differences in abdominal pain and serious adverse events between two groups(P>0.05).The survival length of sand⁃wich TACE group were longer than that of conventional TACE group,but the differences were not significant(P=0.195).Conclusion Sandwich TACE is an effective and well tolerated treatment in massive hepatocellular carcinoma patients.