经导管动脉化疗栓塞在肝细胞癌骨转移治疗中的应用初探

目的初步探讨经动脉化疗栓塞术（TACE）治疗原发性肝细胞癌（HCC）骨转移瘤的应用价值。方法收集中山大学附属第一医院伴有骨转移瘤的HCC患者15例，3例（20．0％）为多发性骨转移，12例（80．0％）为单发转移。TACE治疗骨转移瘤前后行影像学检查，以目测模拟法（VAS法）对局部疼痛程度进行分级，治疗后随访3个月以上。结果所有患者成功行局部骨转移灶TACE治疗，术中无并发症。15例患者术前VAS评分均在7分以上，术后局部疼痛均有不同程度缓解。按VAS评分标准，1个月后随访完全缓解3例，明显缓解7例，轻度缓解5例。治疗后3个月疼痛缓解的有效率为80．0％，至6个月时总体有效率仍达58．3％。影像学评价的治疗有效率达86．7％。TACE后1个月5例患者AFP下降〉50％，8例下降〉30％，2例下降〉20％。术后3个月生存率为100％，6个月生存率为80％。结论TACE可有效控制肝细胞癌骨转移灶的局部生长、缓解疼痛，有助于患者生存质量的提高。

Preliminary investigation of the effect on transcatheter arterial chemoembolization for osseous metastases of hepatocellular carcinoma

Objective To preliminarily investigate the effect of transeatheter arterial ehemoembolization（TACE） for osseous metastases of hepatocellular carcinoma（HCC）. Methods Fifteen cases of HCC eompanied with single（12 cases） or multiple（3 cases） osseous metastases were enrolled. Imageologic examination was performed to the local osseous focuses, and the visual analog scales （VAS） method was used to evaluate the degree of local pain before and after TACE for osseous metastases. Follow- up were performed above 3 months for all patients. Results Fifteen cases successfully underwent TACE for local osseous metastases. The VAS score of all patients were above 7 and the local pain had relieved in varying degrees after therapy. According to VAS criterion, the follow-up visit after one month presented 3 cases with complete relief, 7 cases with distinct relief and 5 cases with mild relief. The effective rate of pain relief was 80.0% at the third month after therapy and 58.3% at the sixth month. The effective rate was 86.7% by imageology evaluation. The AFP level reduced more than 50% in 5 cases, more than 30% in 8 cases and more than 20% in 2 cases. The survival rate of the cases was 100% at the third month after TACE for osseous metastases, while 80% at the sixth month. Conclusion TACE is available to release pain and control of local lesions for osseous metastases of HCC, also improve the quality of life.