影响中晚期肝癌化疗栓塞疗效的因素分析

目的：探讨中晚期肝癌化疗栓塞治疗疗效及影响疗效的因素。方法：对508例不能切除的原发性肝癌行选择性肝动脉插管灌注化疗和／或栓塞治疗共2025次，其中行选择性肝动脉插管灌注化疗栓塞治疗448例，单纯灌注化疗60例，结果：选择性肝动脉插管灌注化疗栓塞1，2，3年生存率分别为81．3％，38．6％，21．6％；单纯灌注化疗1，2，3年生存率分别为54．3％，21．3％，9．6％，肿瘤分类，栓塞剂及用量，门静脉是否有癌栓，侧支循环的形成，碘油沉积情况以及栓塞技术和方法选择是否是影响疗效的主要因素。结论：选择性肝动脉插管灌注化疗栓塞可作为中晚期肝癌的常规治疗，远期疗效明显优于单纯灌注化疗。

Factors Influencing Therapeutic Efficacy of Transcatheter ArterialChemoembolization on Advanced Hepatocellular Carcinoma

Objective:To evaluate therapeutic efficacy of transcatherter arterial chemoembolization (TACE) and its influential factors.Methods:From January 1990 to October 2000,508 patients with unresectable advanced hepatocellular carcinoma (HCC) received 2025 intervention treatments,among which 448 cases were given TACE,and 60 cases were given transcatheter arterial infusion chemotherapy (TAI) alone.Results:The 1-,2-and 3-year overall survival rates were 81.3%?38.%?21.6% and 54.3%?21.3%?9.6%,respectively.Clinical types of the disease,embolizing agents and their dosage,portal infiltration,formation of collateral circulation to the tumor,accumulation of iodized oil,embolizing technique selections were factors affecting treatment efficacy.Conclusions:TACE can be routinely used in the treatment for advanced HCC,and it is more superior in long-term effectiveness than TAI.