小肝癌栓塞化疗的效果观察

目的：探讨小肝癌经导管肝动脉注射碘油抗癌药栓塞化疗（ＴＯＣＥ）的疗效及影响预后的因素。材料与方法：小肝癌３０例，全部接受ＴＯＣＥ治疗后随访３￣５年以上，其中２４例单纯行ＴＯＣＥ治疗，作为Ａ组；另６例ＴＯＣＥ后４￣６周行手术切除，作为Ｂ组。两组分别统计和生存率和死亡原因。结果：Ａ组１、３、５年生存率分别为７９．３％、３７．５％和２２．２％；Ｂ组则为１００％、６６．７％和２５％。生存≥３年的患者主要死

Observation on the Results of Chemoembolization for Small Hepatocellular Carcinoma

Objective: To evaluate the results of transcatheter hepatic artery oily chemoembolization (TOCE) with a mixture of iodized oil and anticancer agents in treating small hepatocellular carcinoma (HCC), and to investigate factors affecting prognosis. Materials and Methods: Thirty patients with small HCC were divided into two groups. Group A, 24 cases, treated by TOCE alone. Group B, 6 cases, surgical remove was performed 46 weeks after TOCE. All patients were followed up for 35 years. Results: The 1,3,5year cumulative survival rates were 79.3%, 37.5% and 22.2% in Group A, and 100%, 66.7% and 25% in Group B, respectively. The main causes of death were intrahepatic recurrence and extrahepatic metastases in patients survived over 3 years, and hemorrhage of upper digestive tract and hepatic failure due to cirrhosis in patients survived less than 3 years. Conclusion: For the treatment of small HCC, TOCE is inferior to other therapeutic methods. Segmental TOCE is recommended, and more satisfactory results may be obtained if coupled with surgical resection or percutaneous ethanol injection. Hemorrhage of upper digestive tract and hepatic failure due to cirrhosis adversely affect shortterm effect of TOCE, and intrahepatic recurrence and extrahepatic metastases adversely affect longterm effect of TOCE.