肝动脉、门静脉双路化疗原发性肝癌(附68例报告)

目的　观察双路化疗 [经导管肝动脉化疗栓塞 (TACE)联合 B超引导下经皮经肝细针穿刺门静脉化疗 (PVE) ]治疗原发性肝细胞肝癌 (HCC)的疗效。方法　 HCC患者 6 8例进行 TACE+PVE,同期选择单纯行TACE患者 2 4例作为对照。结果　 TACE+PVE组和单纯 TACE组的总有效率 (完全缓解 +部分缓解 +无变化 )分别是 5 7.4%和 37.5 %,两组有显著性差异 (P<0 .0 1) ,门静脉癌栓消失 +缩小率两组分别是 5 5 .9%和 2 5 %(P<0 .0 5 )。 1、2、3年生存率 TACE组分别是 6 2 .5 %、37.5 %、2 0 .8%;TACE+PVE组分别是 91.2 %、6 1.8%、39.7%(P<0 .0 5 )。结论　 TACE+PVE治疗 HCC优于单纯 TACE;B超引导下细针穿刺门静脉行 PVE操作简便 ,并发症少 ,有临床推广价值。

Combined chemotherapy by transcatheter arterial and ultrasound-guided porta vein embolization in treatment of hepatocellular carcinoma(68 cases report)

Objective To study the effect of combined chemotherapy by transcatheter arterial (TACE)and Ultrasound-Guided portal vein embolization (PVE)treating hepatocellular carcinoma.Methods Chemotherapy embolization 68 patients with primary hepatocellular carcinoma(HCC) were treated by TACE+PVE, 24 patients with primary HCC were treated only by TACE was contral group.Results The total response rate was 57.4% in TACE+PVE group and 37.5% in TACE group (P<0.001). The tumor thrombi of 55.9% in TACE+PVE group and 25% in TACE group became lessened or resolved (P<0.05). The 1? 2? 3 years survival rate was 62.5%, 37.5% and 20.8% in TACE group and 91.2%? 61.8% and 39.7% in TACE+PVE group repectively(P<0.05).Conclusion The method of TACE +PVE is more effective than that of TACE alone in treatment of patient with primary HCC.The method of PVE is easy, safe and should be widely used in clinical practice.