肝动脉化疗或栓塞治疗神经内分泌肿瘤肝转移的疗效分析

目的 探讨经肝动脉灌注化疗（TAI）或化疗栓塞术（TACE）治疗神经内分泌肿瘤（NET）肝转移的临床疗效和不良反应。方法 收集2002年8月至2009年9月接受介入治疗的48例NET肝转移患者，其中对30例病灶为富血供或中等血供者行TACE治疗，对18例病灶为乏血供者进行TAI治疗。介入治疗后1个月，进行疗效评价。结果 48例患者均顺利完成介入治疗，TACE组平均完成4.5次（2～9次），TAI组平均完成4.1次（1～10次）。所有患者的临床症状均有不同程度减轻，获CR 5例、PR 27例、SD 10例和PD 6例，有效率为66.6%。48例NET肝转移患者的中位肿瘤进展时间（TTP）为10.0个月，中位总生存时间（OS）为28.0个月。TACE组的中位TTP为9.5个月，中位OS为27.0个月；TAI组的中位TTP为8.5个月，中位OS为24.0个月。主要不良反应包括疼痛、发热、乏力、恶心呕吐、白细胞减少等，以1～2级为主。结论 对于不能手术的NET肝转移患者，依其不同血供选择合适的介入治疗方式可以获得较好的治疗效果。

Hepatic transcatheter arterial infusion and chemoembolization in the treatment of liver metastases of neuroendocrine tumors

Objective To evaluate the efficacy and side effect of hepatic transcatheter arterial infusion（TAI） and chemoem- bolization （TACE） in the treatment of liver metastases of neuroendocrine tumors （NET）. Methods Forty-eight patients with liver metastases of NET underwent interventional therapy from August 2002 to September 2009. Thirty patients with rich blood supply and middling blood supply underwent TACE, while 18 patients with poor blood supply underwent TAI. The efficacy was evaluated 1 month after the interventional therapy. Results Interventional therapy was successfully completed in 48 patients. Patients underwent TACE finished 4. 5 times（range 2-9 times） and those underwent TAI finished 4. 1 times（range 1-10 times）. The main symptoms and signs in all patients were relieved at different extent with 5 cases in CR, 27 in PR, 10 in SD and 6 in PD, and the effective rate was 66. 6%. The median time to progression （TrP） was 10. 0 months and the median overall survival （OS） was 28.0 months in 48 patients. In TA- CE group, the median TYP was 9.5 months, and median OS was 27.0 months, while in TAI group were 8.5 months and 24. 0 months. The main side effects were pain, fever, vomiting/nausea, fatigue and leukopenia, mainly in grade 1-2. Conclusion Interventional therapy selecting proper modality based on the metastatic lesion＇s blood supply patterns for unresectable liver metastases of NET may ob- tain satisfactory efficacy.