肝癌合并门静脉癌栓的金属内支架、TACE、PVC三联治疗

目的 探讨经皮穿肝门静脉内支架置入术和经皮穿刺门静脉化疗术(PVC)及经皮穿刺肝动脉化疗栓塞术(TACE)三种方法 联合治疗肝癌合并门静脉癌栓的疗效. 资料与方法 动脉造影观察肝肿瘤血供和门静脉癌栓情况;经皮穿刺门静脉,在癌栓部位置入支架;再从门静脉和肝动脉内灌注化疗和抗肿瘤血管生长药物以及栓塞剂. 结果 本组12例中晚期患者,支架通畅时间2～22 月,中位通畅期5月.治疗后3个月、6个月、12个月、12个月以上生存率分别为91.7%(11/12)、83.3%(10/12)、50%(6/12)、25%(3/12). 结论 肝癌合并门静脉癌栓应用经皮穿肝门静脉内支架置入术、PVC术、TACE术是一种有效的联合治疗方法 .

Study of Combined Metallic Stent, Portal Vein Chemotherapy and Transcatheter Arterial Chemoemboization in Hepatocellular Carcinoma with Portal Vein Tumor Thrombi

Objective To evaluate the effect of combined metallic stent, portal vein chemotherapy (PVC) and transcatheter arterial chemoemboization (TACE) in treatment of hepatocellular carcinomas (HCC) with portal vein tumor thrombi.Methods Arteriography was performed to assess the feeding vessels and portal vein tumor thrombi. The stent was placed within the portal vein through transcutaneous and transhepatic direct puncture of the portal vein. Chemotherapy drugs, antitumor vascular therapy drugs by targeting the vascular endothelial growth factor, and embolic agents were then injected into the tumors and the feeding vessels through the portal vein and hepatic artery. Results In 12 patients with advanced tumors, the median period of the stent keeping patent was 5 months ranging from 2 months to 22 months. The 3-month survival rate, 6-month survival rate, 12-month survival rate, and survival rate up to 12 months was 91.7%, 83.3%, 50% and 25%, respectively. Conclusions Combined metallic stent, PVC and TACE could be an effective method for patients with HCC with portal vein tumor thrombi.