[1]黄文薮,蔡明岳,曾昭吝,等.TACE联合125I放射性粒子植入治疗肝细胞癌门静脉癌栓[J].介入放射学杂志,2015,(06):488-493.
 HUANG Wen- sou,CAI Ming- yue,ZENG Zhao- lin,et al.Transarterial chemoembolization combined with CT- guided 125I seed implantation for the treatment of hepatocellular carcinoma associated with portal vein tumor thrombus[J].journal interventional radiology,2015,(06):488-493.
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TACE联合125I放射性粒子植入治疗肝细胞癌门静脉癌栓()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年06期
页码:
488-493
栏目:
肿瘤介入
出版日期:
2015-06-25

文章信息/Info

Title:
Transarterial chemoembolization combined with CT- guided 125I seed implantation for the treatment of hepatocellular carcinoma associated with portal vein tumor thrombus
作者:
黄文薮 蔡明岳 曾昭吝 黄敬君 黄明声 单 鸿 朱康顺
Author(s):
HUANG Wen- sou CAI Ming- yue ZENG Zhao- lin HUANG Jing- jun HUANG Ming- sheng SHAN Hong ZHU Kang- shun
Department of Radiology, Third Affiliated Hospital of Sun Yet- sen University, Interventional Radiology Institute, Sun Yat- sen University, Guangzhou, Guangdong Province 510630, China
关键词:
【关键词】 肝细胞癌 门静脉癌栓 近距离内照射治疗 肝动脉化疗栓塞
文献标志码:
A
摘要:
【摘要】 目的 探讨TACE联合125I放射性粒子植入治疗肝细胞癌(HCC)门静脉癌栓(PVTT)的方法及疗效。方法 纳入TACE联合CT引导下植入125I放射性粒子治疗的HCC合并PVTT患者48例。根据PVTT部位,分为门静脉主干癌栓(A型)、门静脉一级分支癌栓(B型)和门静脉二级及以下分支癌栓(C型)。根据粒子是否植入到PVTT内,分为癌栓内直接植入法(癌栓内部植入组)和癌栓周围植入法(其粒子植入到癌栓周围1.7 cm内的肝实质或肿瘤内,癌栓周围植入组)。比较不同类型PVTT及不同植入方法的癌栓控制率(DCR)、癌栓进展时间(TTP)及患者总生存率(OS)。结果 48例患者均成功进行TACE及粒子植入治疗。A、B、C型PVTT患者,中位OS(mOS)分别为8、11.5和15个月,组间差异有统计学意义(P=0.003);癌栓DCR分别为61.5%、70.8%和72.7%(P=0.548),肝内肿瘤DCR分别为69.2%、75.0%和81.8%(P=0.483);癌栓中位TTP分别为4.5、8和11个月(P=0.030),肝内肿瘤中位TTP分别为5、9和9.5个月。癌栓内部植入组和癌栓周围植入组的mOS分别为10和11.5个月(P=0.239);癌栓DCR分别为69.2%、68.2%(P=0.591),肝内肿瘤DCR分别为73.1%和77.3%(P=0.502);癌栓中位TTP分别为7和10个月(P=0.276),肝内肿瘤中位TTP分别为8和9.5个月(P=0.089)。结论 TACE联合125I放射性粒子植入治疗HCC伴PVTT,可有效控制PVTT和肝内肿瘤进展,延长患者生存期;癌栓内直接植入法和癌栓周围植入法,对PVTT的疗效无影响。

参考文献/References:

[1] Minagawa M, Makuuchi M. Treatment of hepatocellularcarcinoma accompanied by portalvein tumor thrombus[J]. World J Gastroen- terol, 2006, 12: 7561- 7567.
[2] Llovet JM, Bustamante J, Castells A, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials[J]. Hepatology, 1999, 29: 62- 67.
[3] Bruix J, Sherman M, Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellulacarcinoma[J]. Hepatology, 2005, 42: 1208- 1236.
[4] Tazawa J, Maeda M, Sakai Y, et al. Radiation therapy in combination with transcatheter arterial chemoembolization for hepatocellular carcinoma with extensive portal vein involvement[J]. J Gastroenterol Hepatol, 2001, 16: 660- 665.
[5] Zhu K, Chen J, Lai L, et al. Hepatocellular carcinoma with portal vein tumor thrombus: treatment with transarterial chemoembo- lization combined with sorafenib: a retrospective controlled study[J]. Radiology, 2014, 272: 284- 293.
[6] Lencioni R, Llovet JR. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma [J]. Semin Liver Dis, 2010, 30: 52- 60.
[7] Zeng ZC, Fan J, Tang ZY, et al. A comparison of treatment combinations with and without radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombus[J]. Int J Radiat Oncol Biol Phys, 2005, 61: 432- 443.
[8] 刘 健, 张福君, 吴沛宏, 等. CT导向下125Ⅰ粒子植入治疗肝门区肝癌[J]. 介入放射学杂志, 2005, 14: 606- 609.
[9] 翁志成, 杨维竹, 江 娜, 等. CT引导下125Ⅰ放射性粒子植入治疗肝癌门静脉癌栓的疗效评价[J]. 介入放射学杂志, 2010, 19: 535- 539.
[10] Chung GE, Lee JH, Kim HY, et al. Transarterial chemoembo lization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival [J]. Radiology, 2011, 258: 627- 634.
[11] Luo J, Guo RP, Lai EC, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a prospective comparative study[J]. Ann Surg Oncol, 2011, 18: 413- 420.
[12] Georgiades CS, Hong K. D’angelo M, et al. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis[J]. J Vasc Interv Radiol, 2005, 16: 1653- 1659.
[13] Shi J, Lai EH, Li N, et al. Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus[J]. Ann Surg Oncol, 2010, 17: 2073- 2080.
[14] Niu ZJ, Ma YL, Kang P, et al. Transarterial chemoembolization compared with conservative treatment for advanced hepatoce llular carcinoma with portal vein tumor thrombus: using a new classification[J]. Med Oncol, 2012, 29: 2992- 2997.

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备注/Memo

备注/Memo:
(收稿日期:2014 -11 -17)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2015-06-24