不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用的比较研究

目的 比较研究不同化疗模式及不同给药途径对肝癌合并门静脉癌栓术后化疗作用及其疗效。方法 56例肝癌合并门静脉癌栓手术切除病人，按术后化疗给药途径不同随机分为：(1)未行化疗组(n＝18)；(2)门静脉置管(PVI)化疗组(n＝19例)；(3)PVI 肝动脉置管(HAI)化疗组(n＝19例)；按术后化疗模式不同随机分为：(1)未行化疗组(n＝18)；(2)推注化疗组(n＝18例)，其中10例经PVI给药，8例经PVI HAI给药；(3)持续灌注化疗组(n＝20例)，其中8例经PVI给药，12例经PVI HAI给药。结果 PVI化疗组和PVI HAI化疗组平均生存时间分别为14个月和17个月，两组比较无显著差异(P＞0．05)，但均明显高于术后未化疗组7个月(P＜0．05)。推注化疗组和持续灌注化疗组的平均生存时间分别为13个月和19个月，两组比较有显著差异(P＜0．05)，均明显高于未化疗组(P＜0．05)。结论 肝癌合并门静脉癌栓术后经PVI化疗或经PVI HAI化疗可明显提高疗效，而持续灌注化疗疗效明显优于推注化疗。

Comparison of different chemotherapeutic patterns and drug-administration ways after resection of hepatocellular carcinoma with tumor thrombi in portal vein

Objective To compare the effects of different chemotherapeutic patterns and drug-administration ways on outcome of chemotherapy after resection of hepatocellular carcinoma (HCC) with tumor thrombi in portal vein (PVTT). Methods Fifty-six HCC patients with PVTT were randomly divided into 3 groups according to different ways of chemotherapy after operation: (1) no chemotherapy group (n=18). (2) Portal vein infusion (PVI) chemotherapy group (n=19). (3) PVI+hepatic artery infusion (HAI) chemotherapy group (n=19). Meanwhile, they were randomized into 3 groups based on chemotherapeutic patterns after the operation: (1) no chemotherapy group (n=18). (2) injection chemotherapy group (n=18). In this group, 10 patients received chemotherapy through PVI and other 8 through PVI-HAI. (3) Continuous infusion chemotherapy group (n=20). Of the patients, 8 received chemotherapy though PVI and the other 12 through PVI+HAI. Results The mean survival time of the patients in PVI chemotherapy group and PVI+HAI chemotherapy group was 14 and 17 months, respectively (P>0.05). The mean survival time of the patients in injection chemotherapy group and continuous infusion chemotherapy group was 13 and 19 months, respectively (P<0.05). It was significantly longer than that of patients in no chemotherapy group (P<0.05). Conclusions (1) The effect of chemotherapy through PVI is almost the same as that of the chemotherapy through PVI+HAI. (2) The effect of the continuous infusion chemotherapy through PVI or PVI+HAI is better than that of the injection chemotherapy.