全身化疗联合肝动脉栓塞灌注化疗治疗乳腺癌肝转移的效果

目的:探讨全身化疗联合肝动脉栓塞灌注化疗（TACE）在乳腺癌肝转移中的临床疗效。方法:对68例乳腺癌肝转移患者分别采用全身化疗（化疗组）32例、TACE（栓塞组）13例及两者联合治疗（联合组）23例，比较3组的疗效、不良反应及患者生存时间。结果:全组总有效率为41.18%，化疗组的有效率为43.75%，栓塞组为7.69%，联合组为56.52%；联合组的疗效优于栓塞组（P<0.01），但与化疗组差异无统计学意义（P>0.05）。全组中位随访时间为18个月。全组总中位生存时间为16个月，其中化疗组与联合组的中位生存时间均为19个月，而栓塞组为13个月，3组生存时间差异有统计学意义（P<0.05）。不良反应主要为胃肠道反应、骨髓抑制、脱发及肝功能损害。结论:全身化疗联合TACE在乳腺癌肝转移中疗效较好，且不良反应较轻，值得临床进一步推广。

Effect of the systemic chemotherapy combined with transcatheter arterial chemoembolization in the treatment of breast cancer with liver metastasis

Objective:To explore the effects of systemic chemotherapy combined with transcatheter arterial chemoembolization ( TACE) in the treatment of breast cancer with hepatic metastasis. Methods:Sixty-eight breast cancer patients with liver metastasis were treated with systemic chemotherapy ( 32 cases, chemotherapy group ) , TACE ( 13 cases, embolism group ) , and systemic chemotherapy combined with transcatheter arterial chemoembolization ( 23 cases, combination group ) . The curative effect, adverse reaction and survival time between three groups were compared. Results:The total effective rate was 41. 18%,the effective rates in chemotherapy group,embolism group and combination group were 43. 75%,7. 69% and 56. 52%,respectively. The curative effect in combination group was better than that in embolism group(P<0. 01),the difference of the curative effect between the combination group and chemotherapy group was not statistically significant(P>0. 05). The median following-up time and survival time in all groups were 18 and 16 months,respectively. The median survival time in chemotherapy group and combination group was 19 months,and the median survival time in embolism group was 13 months,and the differences of the survival time between three groups were statistically significant(P <0. 05). The gastrointestinal disorders,bone marrow suppression,hair loss and liver damage were the main adverse reactions in three groups. Conclusions:The treatment of the breast cancer with hepatic metastasis with systemic chemotherapy combined with TACE is good effect and less adverse reaction,which is worth in clinical further promotion.