伴重度肝硬化肝细胞癌的肝动脉节段性化学栓塞疗法

目的 评价肝动脉节段性化学栓塞(TASCE)疗法治疗伴重度肝硬化(Child B级或C级、ICGR_15>10％)肝细胞癌患者的疗效及对肝功能的影响。方法 采用TASCE治疗21例(TASCE组),采用肝动脉化学栓塞(TACE)治疗28例(TACE组)作为对照。结果 TASCE组总缓解率为38.09％,中位生存期为9.8个月,累计生存率:半年为58.38％,1年为33.33％,2年为9.52％TACE组总缓解率为7.14％(P<0.05),中位生存期为4.4个月(P<0.01)和累计生存率半年为21.43％(P<0.05),1年为3.57％(P<0.05),2年为0。肝功能损害加重发生率相比:TASCE组SB为33.33％,ALT为47.62％和AST为52.38％;TACE组分别为82.14％(P<0.01),89.29％(P<0.01)和85.71％(P<0.05)。结论 TASCE治疗伴重度肝硬化肝癌疗效好,副反应小,肝功能损害轻,是一值得推广应用的放射介入治疗手段。

Treatment of hepatocellular cancer with advanced liver cirrhosis by transarterial segmental chemoembolization

Objective To evaluate the effect of transarterial segmental chemoe-mbolization (TASCE) on 21 patients with hepatocellular cancer accompanied by liver cirrhosis (Child B or C, ICGR15 > 10%). Methods Fourty nine cases were allocated into group A(21 cases,by TASCE) and group B (28 cases,by TACE). Results The remission rates of group A and group B were 38. 09% and 7. 14%, respectively (P< 0. 05). The medial survival periods were 9. 8 and 4. 4 months (P<0. 01). The cumulative survival rates at 6 and 12 months were 58. 38% and 21. 43% (P<0. 05), and 33. 3% and 3. 57%, respectively (P<0. 05). The degree of hepatic functional damage in group A was milder than that group of group B. Conclusion TASCE gives better results with less adverse effects than that by TACE,and worth recommendation for wider use.