大剂量碘油与常规TACE治疗巨块肝癌的对比研究

目的探讨大剂量碘油栓塞治疗巨块型肝癌的临床疗效及不良反应。方法79例巨块型肝癌患者,肿块大小为7～18cm。分为A组:常规经肝动脉化疗栓塞组39例(TACE组)一次碘油用量10～20ml。B组:经肝动脉化疗并大剂量碘油栓塞组40例(大剂量组)。一次栓塞治疗中碘油用量为20ml以上。结果TACE组,有效率(CR PR)71.7%(28/39);1～3年生存率为:66.7%(26/39)、33.3%(13/39)、0。大剂量组,有效率(CR PR):87.5%(35/40);1～3年生存率:75%(30/40),45%(18/40),7.5%(3/40)。有效率及生存率两组比较有显著差异。2组均未出现严重的并发症及肝功能损害。结论大剂量碘油栓塞巨块型肝癌的疗效优于常规TACE,肝功能较好的巨块型肝癌适合用大剂量碘油栓塞治疗。

A control study of TACE using high - dosed and routine - dosed iodized oil as a treatment of large hepatocellular carcinoma

Objective To investigate the side effects and curative effect in high-dosed lipiodol-transcatheter arterial chemoembolization as a treatment of large hepatocellular carcinoma. Methods 79 patients with unresectable hepatocell ular carcinoma were treated by TACE, and divided into 2 groups. In group A, 39 patients with the tumor sized 7-18cm in diameter, routine-dosed, 10-20ml lipio dol was given in TACE. 40 patients were enrolled in the high-dosed group B, who were given more than 20ml iodized oil in TACE. Results The First to third year survival rate of group A was 66.7%, 33.3 %, 0%respectively,while in group B it was 75%, 45%, 7.5%respectively. The effective rate was 71.7%in Group A an d 87.5%in Group B. There was a significant difference between both groups. Ther e was no significant difference of critical side effects and liver function dama ge between group A and B. Conclusion High-dosed lipiodol chemoembolization as a treatment of unresectable hepatocellular carcinoma is superior to the routine TACE, especially when the tumor is large and the liver function reserve is good.