肝癌肝移植术后个体化化疗疗效初步分析

目的　探讨肝癌肝移植术后辅助个体化化疗对预防肝癌复发、提高肝癌肝移植疗效的临床意义。方法　回顾分析 2 0 0 1年 4月～ 2 0 0 3年 1月 2 1例肝癌肝移植术后依据ATP TCA结果制定并实施个体化化疗患者的临床资料。 5 2例单纯采用肝移植治疗的肝癌患者作为对照组 ,比较两组肝癌患者的累计生存率和累计无瘤生存率。结果　个体化化疗组和未作化疗组肝移植术后 1年、2年生存率分别为 92 31%、73 85 %和 92 0 6 %、6 3 93% ,两组术后累计生存率比较差异无显著意义 ;个体化化疗组和未作化疗组患者肝移植术后 6、12、18、2 4个月的无瘤生存率分别为 90 0 0 %、80 0 0 %、80 0 0 %、6 0 0 0 %和 6 7 31%、5 1 92 %、4 0 0 3%、37 81% ,二组术后累计无瘤生存率差异有显著意义 (P <0 0 5 )。结论　肝移植术后辅助个体化化疗能显著降低肝癌肝移植术后的肿瘤复发率 ,明显延长肝移植术后的无瘤生存时间。根据ATP TCA技术指导制定的肝癌肝移植术后个体化化疗方案具有临床应用价值。

Clinical study of adjuvant individualized chemotherapy for hepatocellular carcinoma after liver transplantation

Objective To investigate the effect of adjuvant individualized chemotherapy in prevention of tumor recurrence and improvement of patient survival after liver transplantation for hapatocellular carcinoma (HCC). Methods 21 HCC cases received orthotopic liver transplantation and treated with adjuvant individualized chemotherapy based on ATP tumor chemosensitivity assay (ex vivo) between April 2001 and January 2003 were retrospective reviewed, compared with 52 cases received orthotopic liver transplantation only. The cumulative and tumor free survivals were compared between 2 groups. Results The 1, 2 years overall survival rates were 92 31%, 73 85% for the individualized chemotherapy group and 92 06%, 63 93% for the non chemotherapy group, the difference was not statistically significant. The 6, 12, 18, 24 months tumor free survival rates were 90 00%, 80 00%, 80 00%, 60 00% and 67 31%, 51 92%, 40 03%, 37 81% respectively, the difference was statistically significant ( P <0 05). Conclusions This study suggests that tumor recurrence decreases and tumor free survival increases by adjuvant individualized chemotherapy after liver transplantation for HCC. The individualized protocol based on ATP TCA may be effective for patients with HCC after liver transplantation.