肝癌姑息切除术后辅加肝动脉栓塞化疗的疗效

原发性肝癌容易发生肝内转移，所以能得到根治性切除术的病例不多。而对于姑息性切除的病人其疗效不佳，中位生存期也只有６个月左右。本文报道５５例仅作姑息性切除和３９例作姑息性切除后３至４周辅加栓塞化疗的原发性肝癌病人的疗效。随访结果表明：其术后１、２、３、４年生存率在作姑息性切除的病人和作姑息性切除后３至４周辅加栓塞化疗组病人中，分别为８８．０％、３５．８％、０％、０％和８６．０％、６８．４％、５１．８％、３８．７％（Ｐ＞０．０１），其中位生存期分别为７个月和１６个月。     

肝动脉化疗栓塞与肝动脉化疗栓塞联合无水乙醇注射治疗原发性肝癌疗效比较

目的:比较肝动脉化疗栓塞(TACE)与肝动脉化疗栓塞联合无水乙醇注射(PEI)治疗原发性肝癌的治疗效果.方法:52例患者接受TACE治疗,58例患者接受TACE联合PEI治疗,比较两组患者1、2、3年的存活率.结果:TACE联合PEI治疗组2、3年的存活率分别为34.48%,15.51%.显著高于TACE组2、3年的存活率15.38%,1.9%.结论:肝动脉化疗栓塞联合无水乙醇注射治疗较单用肝动脉化疗栓塞治疗能延长原发性肝癌患者存活期.     

原发性肝癌姑息切除术后插管化疗的临床研究

本文对38例原发性肝癌姑息性切除术后,经肝动脉、门静脉插管化疗与38例相同病期仅作姑息性切除的肝癌患者进行配对分析,结果显示插管化疗组AFP转阴率及术后1年生存率均显著高于未插管组,分别为84.8％与 61.3％,55.3％与21.1％(P<0.05).而AFP术后3个月转阳率插管组低于未插管组,分别为50％与74.5％(P<0.05).提示对无法行根除性切除的肝癌患者,在作姑息切除术的同时,行肝动脉、门静脉插管化疗,对提高术后生存率有确切疗效.     

肝动脉栓塞及肝动脉-门静脉双重栓塞化疗治疗中晚期原发性肝癌的疗效比较

背景与目的:临床资料表明,肝的血液由肝动脉和门静脉双重供应,肝癌患者单纯应用肝动脉栓塞化疗(transcatheterarterialchemoembolization,TACE)难以控制肿瘤。本研究旨在探讨经肝动脉行动-门脉双重栓塞化疗(portalvenouschemoembolization,PVCE)治疗中、晚期原发性肝癌的临床价值。方法:回顾性分析1995年7月～1997年7月经肝动脉行动-门脉双重栓塞化疗对58例中、晚期原发性肝癌(TACE+PVCE组)的疗效,与同期行单纯肝动脉栓塞化疗的118例中、晚期原发性肝癌(TACE组)的疗效对比。结果:(1)TACE+PVCE组治疗有效率86.2%,显效率31.0%;TACE组治疗有效率69.5%,显效率13.6%(P<0.05)。(2)TACE+PVCE组半年生存率93.1%,TACE组72.0%;TACE+PVCE组1、4年的生存率分别为43.1%、6.9%;TACE组分别为51.7%、5.1%。寿命表法分析两组患者半年生存率间差异有显著性,1、2、3、4年生存率间差异无显著性。(3)两组患者栓塞后均有发热、腹痛、白细胞下降、肝功能受损发生,TACE+PVCE组肝功能受损较严.-重,甚至可出现黄疸、腹水,肝功能受损程度与碘油用量呈正相关。结论:经肝动脉行动-门脉双重栓塞化疗治疗中、晚期原发性肝癌的短期疗效明显优于单纯行肝动脉栓塞化疗,但中、长期疗效差异无显著性。     

原发性肝癌肝动脉化疗栓塞术的护理

原发性肝癌肝动脉化疗栓塞术的护理王裕珍自１９９０年４月～１９９４年４月，我们采用Ｓｅｌｄｉｎｇｅｒ氏法，对２６例不能手术切除的原发性肝癌患者行肝动脉化疗栓塞术（ＨＡＩ＋ＨＡＥ），共３１人次，现将护理体会总结如下。资料和方法一、临床资料２６例患者均经Ｂ...     

单纯肝动脉栓塞化疗和三维适形放疗联合肝动脉栓塞化疗对原发性肝癌的疗效比较

目的比较单纯肝动脉栓塞化疗和肝动脉栓塞化疗联合三维适形放疗对原发性肝癌的疗效。方法 48例原发性肝癌患者,随机分为单纯TACE组和TACE联合3DCRT组,按照WHO肿瘤评定标准评价近期疗效,以3年内生存率为指标评价远期疗效。结果 TACE组24例患者中完全缓解（CR）0例,部分缓解（PR）13例,总有效率（CR＋PR）为54.17%。TACE联合3DCRT组24例患者中完全缓解（CR）1例,部分缓解（PR）16例,总有效率（CR＋PR）为70.83%。TACE组1、2、3年生存率分别为58.33%、33.33%和16.67%;TACE联合3DCRT组1、2、3年生存率分别为79.17%、54.17%和25.00%。结论 TACE联合3DCRT组疗效优于TACE组。     

肝动脉灌注化疗,栓塞化疗治疗中晚期原发性肝癌

３９例原发性肝癌共作９０次肝动脉灌注化方（ＴＡＩ）或栓塞化疗（ＴＡＥ），１８例作灌注、２１例作栓塞化疗。综合评价结果是，有效率为６６．６７％（２６／３９），半年生存率为８２．０５％。对该法的治疗价值；灌注和栓塞化疗的选择；ＡＦＰ的提示性；并发症和它们的处理或预防进行了讨论。     

原发性肝癌肝动脉栓塞化疗预后影响因素的分析

原发性肝癌 (ｈｅｐａｔｏｃｅｌｌｕｌａｒｃａｒｃｉｎｏｍａ ,ＨＣＣ)肝动脉化疗栓塞 (ｔｒａｎｓｃａｔｈｅｔｅｒａｒｔｅｒｉａｌｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ ,ＴＡＣＥ)疗效肯定[1～ 4 ] ,但影响患者预后的因素很多[5～ 6 ] 。作者收集我院 1990年 1月～ 2 0 0     

Health-Related Quality of Life of Patients with Intermediate Hepatocellular Carcinoma after Liver Resection or Transcatheter Arterial Chemoembolization

Background: The aim of our present study was to compare quality of life (QoL) between intermediate-stage(BCLC-B) HCC patients who had undergone either liver resection or transcatheter arterial chemoembolization(TACE). Materials and Methods: A total of 102 intermediate-stage HCC patients participated in our study,including 58 who had undergone liver resection and 44 who had undergone TACE. Baseline demographiccharacteristics, tumor characteristics, and long-term outcomes, such as tumor recurrence, were compared andanalyzed. QoL was assessed using the Short Form (SF)-36 health survey questionnaire with the mental andphysical component scales (SF-36 MCS and PCS). This questionnaire was filled out at HCC diagnosis and 1,3, 6, 12, 24 months after surgery. Results: For the preoperative QoL evaluation, the 8 domains related to QoLwere comparable between the two groups. The PCS and MCS scores were significantly decreased in both theTACE and resection groups at1 month after surgery, and this decrease was greater in the resection group.These scores were significantly lower in the resection group compared with the TACE group (P<0.05). However,these differences disappeared at 3 and 6 months following surgery. One year after surgery, the resection groupshowed much higher PCS scores than the TACE patients (P=0.018), and at 2 years after surgery, the PCS andMCS scores for the resection group were significantly higher than those for the TACE group (P<0.05). Elevenpatients (19.0%) in the resection group and 17 (38.6%) in the TACE group suffered HCC recurrence (P<0.05).Univariate and multivariate analyses indicated that tumor recurrence (HR=1.211, 95%CI: 1.086-1.415, P=0.012)was a significant risk factor for poorpostoperative QoL in the HCC patients.Conclusions: Due to its effectson reducing HCC recurrence and improving long-term QoL, liver resection should be the first choice for thetreatment of patients with intermediate-stage HCC.     

肝动脉化疗栓塞术联合支持治疗伴HBV感染的中晚期原发性肝癌

[目的]探讨肝动脉化疗栓塞术（TACE）联合支持治疗对伴有乙肝病毒（HBV）感染的中晚期原发性肝癌（PLC）的疗效。[方法]入组伴有HBV感染的中晚期PLC 52例,分为支持治疗组和TACE组,其中支持治疗组给予支持治疗和抗病毒治疗,TACE组在支持治疗和抗病毒治疗的同时给予TACE治疗。治疗结束后分别评价两组的疗效和不良反应。[结果]支持治疗组和TACE组术后1年血清HBV DNA转阴率分别为45.0%和46.9%,差异无统计学意义（P〉0.05）。两组有效率分别为30.0%、59.4%,疾病控制率分别为55.0%、87.5%,差异均有统计学意义（P〈0.05）;1年生存率分别为40.0%、75.0%,2年生存率分别为5.0%、37.5%,差异均有统计学意义（P〈0.05）;中位生存期分别为10个月和19个月;生活质量改善率分别为80.0%和84.4%（P〉0.05）。支持治疗组无明显不良反应出现,TACE组主要不良反应为恶心呕吐和骨髓抑制,但均为Ⅰ～Ⅱ度。[结论]TACE联合支持治疗应用于伴有HBV感染的中晚期PLC患者疗效较好,且不良反应可耐受。     

原发性肝癌患者肝动脉化疗栓塞术后疼痛的影响因素分析

[目的]探讨肝癌患者行经肝动脉化疗栓塞术(TACE)后疼痛的发生情况及影响因素。[方法]对行TACE患者临床基线资料和术后疼痛发生情况进行分析,运用单因素和多因素Lo-gistic回归方法统计分析与TACE术后疼痛发生相关的因素。[结果]研究期间共115例有效病例,其中发生中重度疼痛46例,发生率40%,无疼痛及轻度疼痛69例,发生率60%。多因素Lo-gistic回归提示,与TACE术后发生疼痛具有显著相关性的因素包括:术中使用明胶海绵(P<0.001)、肿瘤位置靠近肝包膜(2cm以内)(P=0.046)。[结论]肝癌患者行TACE术后发生疼痛与术中使用明胶海绵、病灶位置靠近肝脏包膜有着显著关系。     

直肠癌姑息性切除联合肝动脉栓塞化疗治疗晚期直肠癌的临床研究

目的 探寻直肠癌伴不能手术切除的肝转移的有效治疗方法.方法 回顾性分析我院行直肠癌姑息性切除加肝动脉多次栓塞化疗的26例直肠癌同时伴不能手术切除的肝转移患者的临床资料.26例患者均于术前1月先行肝动脉栓塞化疗1次,1月后再行直肠癌姑息性切除,术后1月再行肝动脉栓塞化疗,以治疗后CT复查肝转移瘤全部碘化油沉积为标准,每...     

MRI对肝动脉栓塞化疗治疗肝癌近期疗效随访的价值

[目的]评估MRI对经肝动脉栓塞化疗（transcatheter arterial chemoembolization,TACE）治疗肝癌近期疗效随访的价值。[方法]回顾性分析肝癌手术切除后复发22例患者（36个病灶）经TACE治疗后的MRI表现。[结果]MRI可正确判断22例患者（36个病灶）肝癌在TACE治疗后的近期疗效。随访1年,肿瘤完全凝固坏死32个,残留癌灶4个,2例患者在TACE治疗后1～3个月出现复发。[结论]MRI能准确评估TACE治疗肝癌的近期疗效。     

经肝动脉灌注化疗栓塞术与单纯肝动脉灌注术对胃癌肝转移瘤的疗效对比

目的：比较经肝动脉灌注化疗栓塞术（ TACE）与单纯肝动脉灌注术（ TAI）治疗胃癌肝转移瘤的疗效。方法回顾性分析50例胃癌肝转移患者的临床资料。结果 TACE组有效率和控制率[76％（19／25）和92％（23／25）]均明显较TAI组[28％（7／25）和68％（17／25）]高（P＜0．05）;TACE组0．5、1、2生存率[92％（23／25）、56％（14／25）、16％（4／25）]均明显较TAI组[64％（16／25）、40％（10／25）、8％（2／25）]高（P＜0．05）;两组不良反应发生率[36％（9／25）、28％（7／25）]比较差异不显著（ P＞0．05）。结论经肝动脉灌注化疗栓塞术较单纯肝动脉灌注术治疗胃癌肝转移瘤的疗效好。     

TACE治疗中晚期原发性肝癌108例生存分析

 目的探讨经导管肝动脉化疗栓塞术（TACE）治疗中晚期原发性肝癌(primary liver cancer,PLC)的生存率及其影响因素。方法 回顾性分析108例接受TACE治疗的中晚期PLC患者临床资料;寿命表法计算生存率,Log-rank法单因素分析预后因素,Cox比例风险模型确定独立危险因素。结果TACE治疗后6、12、24、36、48月生存率分别为59.26%、34.41%、14.03%、10.23%、5.12%;单因素分析显示,肿瘤最大直径、门静脉癌栓及远处转移是影响生存率的重要因素,Cox比例风险回归模型分析显示肿瘤最大直径＞10 cm、存在门静脉癌栓是影响生存率的独立危险因素。结论TACE是治疗中晚期PLC的有效方法;肿瘤大小和门静脉癌栓是影响患者预后的重要因素。     

Quality of Life after Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation in Patients with Unresectable Hepatocellular Carcinoma Compared with Transcatheter Arterial Chemoembolization alone

Aim: The aim of this study was to assess quality of life (QoL) in patients with unresectable hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) compared to TACE plus radiofrequency ablation (RFA) done at the same sitting, and to assess tumor therapy response after these 2 palliative interventions. Methods: 73 patients with unresectable HCC (BCLC-B) were included. Patients with tumor ≤ 5 cm were subjected to TACE (N = 45) while patients with tumors > 5 cm were subjected to TACE followed immediately by RFA (N = 28). QoL was evaluated with two validated questionnaires (EORTC QLQ-30 and EORTC HCC18). These questionnaires were filled out before intervention, 2 weeks and 2 months after intervention. Pre/post interventional changes were analyzed. The modified response evaluation criteria in solid tumor (mRECIST) were employed for the evaluation of therapeutic efficacy. Results: Baseline global health status/QoL was significantly higher in TACE group (64.1%) compared to TACE-RFA group (51.2%). Two weeks after intervention: the absolute decrease in global health state was higher in TACE-RFA (- 12.1%) compared to TACE (- 6.3%, p = 0.411). Less impairment was found in TACE group compared to TACE-RFA group for physical/social functioning, fatigue and pain but it was statistically insignificant. Two months after intervention; TACE-RFA group showed significant improvement in global health score, social and physical functioning scores, as well as significant improvement in pain and fatigue compared to TACE group. The therapeutic efficacy of TACE-RFA was better than TACE alone: complete remission, partial remission, stable disease and progressive disease were 17.9%, 32.1%, 42.9% and 7.1% Vs11.1%, 22.2%, 48.9% and 17.8%, respectively). Conclusion: Neither TACE nor TACE-RFA showed a significant decrease in QoL in patients with unresectable HCC two weeks after intervention. However, two months after intervention; TACE-RFA showed significant improvement in global health score compared to TACE monotherapy. TACE-RFA appeared safe, effective and more favorable than TACE monotherapy.     

肝癌术后预防性肝动脉化疗栓塞对延缓复发的意义

[目的]了解预防性肝动脉化疗栓塞术(TACE)在延缓肝癌手术后复发方面的作用.[方法]对823例行根治性切除并经病理证实为肝细胞癌患者进行随访分析.其中126例患者手术后行预防性TACE,将可能影响原发性肝癌术后复发的观察指标包括性别、年龄、术前AFP、有无癌栓、手术切缘、手术前肿瘤是否破裂、肿瘤大小、肿瘤有无子灶、肿瘤包膜情况、手术后有无行预防性TACE等,用Cox模型分析各因素与复发时间之间的关系.所有数据经SAS6.12和SPSS统计软件处理分析.[结果]年龄小、有癌栓、手术前肿瘤有破裂、肿瘤体积大和肿瘤周围有子灶等因素使肝癌手术后复发时间提前,保证较大手术切缘距离和手术后行预防性TACE可延缓肝癌手术后复发.预防性TACE可明显降低肝癌患者术后2年的复发率.[结论]对有早期复发病理学征象的肝癌患者行预防性TACE治疗可能延缓术后肿瘤复发.     

肝动脉化疗栓塞术治疗中晚期肝癌120例疗效分析

目的 观察经导管肝动脉化疗栓塞术(TACE)治疗中晚期原发性肝癌的疗效、毒副反应.方法 采用 Seldinger技术,经股动脉穿剌,选择性肝动脉插管灌注化疗药物联合碘油栓塞或加用明胶海绵治疗中晚期原发性肝癌患者120例,共行 280次介入治疗.结果 全组120例患者中,完全缓解60.0%(72/120),部分缓解31.7%(38/120),稳定8.3%(10 /120),12个月以上生存率达63.3%(76/120).结论 TACE治疗中晚期原发性肝癌疗效确切,能够显著延长患者的生存期,提高其生存质量.