TACE和TAI在单发原发性肝癌切除术后辅助性介入治疗中的效果比较

目的比较经肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)和肝动脉灌注化疗(transcatheter arterial infusion,TAI)在单发原发性肝癌切除术后辅助性介入治疗中的效果。方法 94例行手术切除的单发原发性肝癌患者根据术后辅助性介入方法不同,分为TACE组(n=49)和TAI组(n=45),同期选取术后均未行预防性介入治疗的30例作为对照组。TAI组采取单纯化疗药物灌注化疗,TACE组采用化疗药物与碘油混悬剂,所有患者随访至2016年9月,比较三组患者术后肿瘤复发情况,利用Kaplan-Meier分析三组患者无复发生存期。结果 TACE组和TAI组患者术后1年复发率分别为14.3%和13.3%,均低于对照组的46.7%,差异有统计学意义(P0.05);TACE组患者术后2年和3年复发率分别为21.4%和30.3%,均低于TAI组和对照组,差异均有统计学意义(P0.05)。对于中位无复发生存期,TACE组34.30个月,TAI组24.71个月,对照组12.90个月,Log-Rank检验显示差异具有统计学意义(χ2=34.228,P0.001)。结论相比于TAI,TACE可有效降低患者术后2年和3年复发率,延长患者无复发生存期,有助于改善患者预后。

Effects of TACE and TAi in adjuvant interventional therapy for single primary liver cancer af-ter resection

Objective To investigate the effects of TACE and TAI in adjuvant interventional therapy for single primary liver cancer after resection.Methods Ninety-four cases of patients with single primary liver can-cer underwent surgical resection were divided into TACE group (n=49) and TAI group (n=45), according to the methods of adjuvant interventional therapy after resection. In the same period, 30 cases of patients who did not accept adjuvant interventional therapy were selected as the control group. Patients in TAI group were taken single chemotherapeutic agent, while patients in TACE group were taken suspensions of chemotherapeutic agent and iodized. All patients were followed up until Sep. 2016. The tumor recurrences in the three groups were compared. The relapse-free survival times in the three groups were analyzed using Kaplan-Meier analysis.Results The one-year recurrence rates in the TACE group and TAI group were 14.3% and 13.3%, respectively, which were lower than that in the control group (46.7%), the differences were statistically significant (P<0.05). The 2-year and 3-year recurrence rate in TACE group were 21.4% and 30.3%, respectively, which were lower than those in the TAI group and control group, the differences were statistically significant (P<0.05). The median relapse-free sur-vival time in TACE group was 34.30 mon, while in TAI group and control group were 24.71 mon and 12.90 mon, respectively. Log-Rank test showed that the differences were statistically significant (χ2=34.228,P<0.001).Con-clusion Compared with TAI, TACE can effectively reduce 2-year and 3-year recurrence rate, prolong relapse-free survival time and improve the prognosis of hepatocellular carcinoma patients after resection.