肝动脉药物灌注加化疗栓塞治疗胆囊癌肝转移疗效评价

目的评价肝动脉药物灌注加化疗栓塞治疗胆囊癌肝转移患者临床价值。方法30例胆囊癌肝转移患者均采用肝动脉药物灌注加化疗栓塞,共介入治疗110周期,化疗药物为吉西他滨＋顺铂,栓塞剂采用超液化碘油。所有患者每次介入治疗前均行增强CT测量肿瘤大小,采用RECIST标准评价疗效。采用Kaplan-Meier计算生存率。随访期限直至患者死亡。结果本组患者完全缓解（CR）3%（1例）,部分缓解（PR）50%（15例）,病变稳定（SD）20%（6例）,病变进展（PD）27%（8例）,总有效率（CR＋PR）53%（16例）。1年生存率60%,2年生存率20%。介入治疗始中位生存期13月,中位无进展生存期11月。结论肝动脉药物灌注加化疗栓塞是治疗无法手术切除胆囊癌肝转移患者的有效方法。

Evaluation of efficacy of transarterial therapies of liver metastases from gallbladder cancer

Objective To evaluate local tumor control and survival time after transarterial therapies in the palliative treatment of unresectable liver metastases in patients with gallbladder cancer. Methods A total of 30 patients with unresectable liver metastases of gallbladder cancer were repeatedly treated with transarterial therapies in 28-day intervals. A total of 110 transtarterial therapies procedures were performed （mean,3.7 sessions per patient）. The local chemotherapy protocol consisted of Gemcitabine and Cisplatin. Embolization was performed with lipiodol. Tumor response was evaluated with enhanced CT. The change in tumor size was calculated and the response was evaluated according to the Response Evaluation Criteria in Solid Tumors. Survival rates from first chemoembolization session were calculated according to the Kaplan-Meier method. Follow-up imaging was performed until patients’ death. Results Evaluation of local tumor control resulted in completed response （1 patients,3%）,partial response （15patients,50%）,stable disease （6 patients,20%）,and progressive disease （8 patients,27%）,and the 1-year survival rate was 60%,the 2-year survival rate was 20%. Median survival from the start of chemoemoblization treatment was 13 months,and median progression-free survival time was 11 month. Conclusion Transarterial therapies are minimally invasive therapy options for palliative treatment of liver metastases in patients with gallbladder cancer.