肝动脉化疗栓塞联合门静脉免疫化疗对预防肝癌切除术后复发的价值
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菅志远

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The value of transarterial chemoembolization and portal vein immuno-chemotherapy on prevention of recurrence after resection of hepatic carcinoma
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    目的:探讨肝动脉化疗栓塞联合门静脉免疫化疗对预防原发性肝癌切除术后复发和延长患者生存期的价值。
    方法:对3年间收治的168例原发性肝癌,按治疗方法不同分为4组:(1)手术切除并行肝动脉化疗栓塞联合门静脉免疫化疗47例(A组),(2)手术切除+单纯肝动脉化疗栓塞52例(B组),(3)肝切除+门静脉免疫化疗42例(C组),(4)肝切除+全身静脉化疗27例(D组)。回顾性分析对比各组的治疗效果。
    结果:A,B,C,D组患者术后平均复发时间分别为(18.1±9.5),(15.2±7.6),(13.3±5.4)和(10.0±3.7)个月(P<0.001);术后生存期分别为(24.8±10.2),(19.6±6.8),(19.0±5.5)和(14.4±3.7)个月(P<0.001);从确认复发至研究终点的时间分别为(12.6±7.7),(6.8±2.4),(7.7±3.8)和(5.2±2.9)个月(P<0.001)。
    结论:肝癌切除术后联合行肝动脉化疗栓塞和门静脉免疫化疗较任何一种单一途径更能有效地降低复发率,延长患者生存时间。

    Abstract:

    To explore the value of transarterial chemoembolization (TACE) and portal vein immuno-chemotherapy on the prevention of recurrence after resection of primary hepatic carcinoma and survival.
    Methods :The clinical data and outcome of 168 patients with primary hepatic carcinoma from 2004 to 2007 in Taihe Hospital were analyzed,Among them, 47 underwent hepatectomies plus adjuvant transarterial chemoembolization and immuno-chemotherapy via portal vein (group A); 52 cases had hepatectomies plus transarterial chemoembolization (group B); 42 cases had hepatectomies plus immuno-chemotherapy via portal vein (group C),and 27 cases had hepatectomies plus systemic vein chemotherapy (group D).
    Results:The recurrence rate of the A, B,C and D groups was 53.2%(25/47),65.4%(34/52),73.8%(31/42) and 85.2%(23/27) respectivly,(χ=9.065, P=0.028). The mean recurrence time (tumor free survival time) after operation in group A, B,C and D was (18.1±9.5), (15.2±7.6), (13.3±5.4) and (10.0±3.7) months respectively (P<0.001), while the survival time was (24.8±10.2), (19.6±6.8), (9.0±5.5) and (14.4±3.7) months respectively (P<0.001), and the time between the confirmed recurrence and the studied end-point was (12.6±7.7), (6.8±2.4), (7.7±3.8) and (5.2±2.9) months respectively (P<0.001).
    Conclusions:For primary hepatic carcinoma,after hepatectomy, using transarterial chemoembolization combined with immuno-chemotherapy via portal vein could decrease the recurrence rate,delay the time of recurrence and prolong the survival time,and more effectively than either transarterial chemoembolization or immuno-chemotherapy alone.

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菅志远, 兰明银, 江斌, 曾少波, 周平, 张敏.肝动脉化疗栓塞联合门静脉免疫化疗对预防肝癌切除术后复发的价值[J].中国普通外科杂志,2009,18(7):7-.
DOI:10.7659/j. issn.1005-6947.2009.07.007

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  • 在线发布日期: 2009-07-25