门静脉支架同步125I粒子条植入序贯经导管动脉化疗栓塞术治疗肝癌伴门静脉癌栓

目的观察门静脉支架同步¹²⁵I粒子条植入序贯经导管动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)伴门静脉癌栓的临床价值。方法对15例HCC伴门静脉癌栓患者行门静脉支架同步¹²⁵I粒子条植入序贯TACE治疗,并随访至死亡;观察技术成功率、并发症,分析生存时间、支架通畅时间、累积生存率及支架通畅率。结果15例手术均成功,术中未见严重并发症。术后中位生存期为8.5个月;1、3、6、9、12、15、18和20个月累积生存率分别为100%、86.67%、73.33%、46.67%、26.67%、13.33%、6.67%和0;中位支架通畅中位时间8.5个月,1、3、6、9、12、15和18个月支架累积通畅率为100%、86.67%、80.00%、80.00%、53.33%、46.67%和40.00%。结论门静脉支架同步¹²⁵I粒子条植入序贯TACE治疗HCC伴门静脉癌栓安全、可行,并可延长支架通畅时间和生存期。

Portal vein stenting synchronized 125I seed linear implantation followed by transcatheter arterial chemoembolization in treatment of hepatocellular carcinoma with portal vein tumor thrombus

Objective To explore the clinical value of portal vein stenting synchronized ¹²⁵I seed linear implantation followed by transcatheter arterial chemoembolization (TACE) in treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods A total of 15 patients with HCC accompanied with PVTT underwent portal vein stenting and synchronized ¹²⁵I seed linear implantation followed by TACE. All patients were followed-up until death. The operation success rate and complications were observed, the survival time, cumulative survival rates, stent patency time and stent patency rates were analyzed. Results The oprations were successfully performed in all 15 patients. No serious operational complication occurred. The median survival time was 8.5 months, and the cumulative survival rate at 1, 3, 6, 9, 12, 15, 18 and 20 months was 100%, 86.67%, 73.33%, 46.67%, 26.67%, 13.33%, 6.67% and 0, respectively. The median stent patency time was 8.5 months, and the cumulative patency rate at 1, 3, 6, 9, 12, 15 and 18 months was 100%, 86.67%, 80.00%, 80.00%, 53.33%, 46.67% and 40.00%, respectively. Conclusion Portal vein stenting synchronized ¹²⁵I seed linear implantation followed by TACE was safe and feasible for treating HCC with PVTT, which might result long stent patency and survival time.