寄生性血管供应的43例肝癌化学药物栓塞后的治疗对策与效果

The management of liver cancer with blood supply from parasitic vessels after transcatheter arterial chemoembolization

目的 研究寄生性血管供应的肝癌化学药物栓塞治疗后的效果与对策。方法 造影证实肝癌有寄生性血管供应 43例。经栓塞治疗后辅以化学治疗或注射无水酒精 ,观察其癌灶缩小的情况、生存期 ,并动态观察SIL 2R、AFP等变化情况。结果 有寄生性血管供应的肝癌以巨块型为主 ,栓塞后化学药物治疗 (化疗 )组癌灶缩小多于 5 0 %者 3例 ,占 15 % ,1、3、5年累积生存率分别 5 5 %、12 2 %和 0 ,sIL 2R、AFP降低程度慢 ,且易反弹 ,注射无水酒精组肝癌缩小多于 5 0 %者 7例 ,占 30 % ,1、3、5年累积生存率分别 5 2 %、35 %和 9%。结论 有寄生性血管供应的肝癌化学药物栓塞后效果欠佳 ,辅以无水酒精注射治疗 ,癌灶缩小明显 ,3、5年累积生存率明显提高 ,sIL 2R、AFP可作为疗效监测指标。

ObjectiveTo study the effect of therapeutic strategies for liver cancer with blood supply from parasitic vessels after undergoing transcatheter arterial chemoembolization (TACE). MethodsForty-three liver cancer cases with parasitic arterial blood supply verified by angiography received consecutively TACE, adjuvant chemotherapy or percutaneous ethanal injection (PEI). Tumor shrinkage, patients survival, change of sIL-2R and AFP level were observed.ResultsLiver cancer with parasitic arterial blood supply was all of macronodular type.Tumor shrinkage >50% after TACE plus chemotherapy was observed in 3 cases(15%). The accumulated 1?3?5 year′s survial rate were 55%?12.2%?and 0%, respectively.sIL-2R?AFP level experienced only a transient decline.Tumor shrinkage >50% was seen in 7 cases after TACE and PEI(30%),and the 1?3?5 year′s survival rate was 52%?35%? and 9%,respectively.Conclusions Adjuvant chemotherapy was hardly beneficial to the treatment of liver cancer with parasitic blood supply after TACE, while PEI enhanced effect of TACE as a supplementary therapy as judged by long term survival. The change of sIL-2R, AFP level was a sensitive indicator for the outcome of the treatment.