中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
3期
274-278
,共5页
癌,肝细胞%微球体%碘化油%栓塞,治疗性%治疗结果
癌,肝細胞%微毬體%碘化油%栓塞,治療性%治療結果
암,간세포%미구체%전화유%전새,치료성%치료결과
Carcinoma,hepatocellular%Microspheres%Iodized oil%Embolization,therapeutic%Treatment outcome
目的 探讨经导管微球加碘化油化疗栓塞治疗巨块型肝细胞癌(HCC)的临床疗效.方法 对156例确诊的巨块型HCC患者,按随机数字表法分成M、L、M+L3组,每组52例.M组选用微球进行栓塞至肿瘤血管血流基本截断.L组单纯选用超液态碘化油栓塞.M+L组先用总量1/3～1/2的碘化油栓塞,然后选用微球栓塞至肿瘤血管不显影.对比3组患者对栓塞的反应、肝功能和血清甲胎蛋白(AFP)变化、有效率(病灶完全消失+病灶缩小的比例)、获益率(病灶完全消失+病灶缩小+病灶稳定的比例)、180 d及360 d生存率以及是否有栓塞并发症等,以探讨疗效.计数资料采用χ2检验,计量资料采用方差分析.结果 M组总有效率为38.5%(20/52),获益率为73.1%(38/52),180 d及360 d生存率分别为88.5%(46/52)、82.3%(43/52);L组总有效率为42.3%(22/52),获益率为76.9%(40/52),180 d及360 d生存率分别为86.5%(45/52)、75.0%(39/52);M+L组总有效率为55.8%(29/52),获益率为88.5%(46/52),180 d及360 d生存率分别为94.2%(49/52)、86.5%(45/52).采用χ2检验比较,M+L组与M组、L组的有效率及获益率差异有统计学意义(χ2值分别为6.27、6.16,P值均＜0.05).同时,术后M组、L组与M+L组的发热发生率分别为63.4%(33/52)、86.5%(45/52)、69.2%(36/52)、恶心呕吐发生率分别为67.3%(35/52)、84.6%(44/52)、76.9%(40/52)、肝区疼痛发生率分别为59.6%(31/52)、86.5%(45/52)、73.1%(38/52),采用χ2检验比较差异也有统计学意义(χ2值分别为6.55、6.22、6.90,P值均＜0.05).结论 微球+碘化油联合栓塞治疗原发性巨块型HCC较单独使用碘化油或微球栓塞更有效,且不良反应发生率低.
目的 探討經導管微毬加碘化油化療栓塞治療巨塊型肝細胞癌(HCC)的臨床療效.方法 對156例確診的巨塊型HCC患者,按隨機數字錶法分成M、L、M+L3組,每組52例.M組選用微毬進行栓塞至腫瘤血管血流基本截斷.L組單純選用超液態碘化油栓塞.M+L組先用總量1/3～1/2的碘化油栓塞,然後選用微毬栓塞至腫瘤血管不顯影.對比3組患者對栓塞的反應、肝功能和血清甲胎蛋白(AFP)變化、有效率(病竈完全消失+病竈縮小的比例)、穫益率(病竈完全消失+病竈縮小+病竈穩定的比例)、180 d及360 d生存率以及是否有栓塞併髮癥等,以探討療效.計數資料採用χ2檢驗,計量資料採用方差分析.結果 M組總有效率為38.5%(20/52),穫益率為73.1%(38/52),180 d及360 d生存率分彆為88.5%(46/52)、82.3%(43/52);L組總有效率為42.3%(22/52),穫益率為76.9%(40/52),180 d及360 d生存率分彆為86.5%(45/52)、75.0%(39/52);M+L組總有效率為55.8%(29/52),穫益率為88.5%(46/52),180 d及360 d生存率分彆為94.2%(49/52)、86.5%(45/52).採用χ2檢驗比較,M+L組與M組、L組的有效率及穫益率差異有統計學意義(χ2值分彆為6.27、6.16,P值均＜0.05).同時,術後M組、L組與M+L組的髮熱髮生率分彆為63.4%(33/52)、86.5%(45/52)、69.2%(36/52)、噁心嘔吐髮生率分彆為67.3%(35/52)、84.6%(44/52)、76.9%(40/52)、肝區疼痛髮生率分彆為59.6%(31/52)、86.5%(45/52)、73.1%(38/52),採用χ2檢驗比較差異也有統計學意義(χ2值分彆為6.55、6.22、6.90,P值均＜0.05).結論 微毬+碘化油聯閤栓塞治療原髮性巨塊型HCC較單獨使用碘化油或微毬栓塞更有效,且不良反應髮生率低.
목적 탐토경도관미구가전화유화료전새치료거괴형간세포암(HCC)적림상료효.방법 대156례학진적거괴형HCC환자,안수궤수자표법분성M、L、M+L3조,매조52례.M조선용미구진행전새지종류혈관혈류기본절단.L조단순선용초액태전화유전새.M+L조선용총량1/3～1/2적전화유전새,연후선용미구전새지종류혈관불현영.대비3조환자대전새적반응、간공능화혈청갑태단백(AFP)변화、유효솔(병조완전소실+병조축소적비례)、획익솔(병조완전소실+병조축소+병조은정적비례)、180 d급360 d생존솔이급시부유전새병발증등,이탐토료효.계수자료채용χ2검험,계량자료채용방차분석.결과 M조총유효솔위38.5%(20/52),획익솔위73.1%(38/52),180 d급360 d생존솔분별위88.5%(46/52)、82.3%(43/52);L조총유효솔위42.3%(22/52),획익솔위76.9%(40/52),180 d급360 d생존솔분별위86.5%(45/52)、75.0%(39/52);M+L조총유효솔위55.8%(29/52),획익솔위88.5%(46/52),180 d급360 d생존솔분별위94.2%(49/52)、86.5%(45/52).채용χ2검험비교,M+L조여M조、L조적유효솔급획익솔차이유통계학의의(χ2치분별위6.27、6.16,P치균＜0.05).동시,술후M조、L조여M+L조적발열발생솔분별위63.4%(33/52)、86.5%(45/52)、69.2%(36/52)、악심구토발생솔분별위67.3%(35/52)、84.6%(44/52)、76.9%(40/52)、간구동통발생솔분별위59.6%(31/52)、86.5%(45/52)、73.1%(38/52),채용χ2검험비교차이야유통계학의의(χ2치분별위6.55、6.22、6.90,P치균＜0.05).결론 미구+전화유연합전새치료원발성거괴형HCC교단독사용전화유혹미구전새경유효,차불량반응발생솔저.
Objective To evaluate the clinical therapeutic effect with microspheres embolization for giant hepatocellular carcinoma(HCC). Methods A prospective study was performed for 156 HCC patients needed for TACE, then randomly signed them into group M (embolized by microspheres alone), group L (embolized by lipiodol alone) and group M + L (embolized by microspheres combined with lipiodol). TACE of group M was performed by 300-700 μm microspheres. Group L selected lipiodol alone to embolize. While group M + L were embolized by about 1/3-1/2 lipiodol of total embolized volume and then microspheres feeding individual tumor vessels. Stoped the procedure when caused terminal vessel blockade. Before and after therapy, patients'liver function, serum α-fetoprotein level (AFP), responses of tumor, complications related to embolization and survive rates of 180 days and 360 days were analyzed among three groups.Enumeration data such as survive rates and positive response were compared by χ2 test, while measurement data were analyzed by one-way classification. Results The positive response (CR + PR) of group M was 38.5% (20/52)and (CR + PR + SD)73. 1% (38/52). Survive rates of 180 days and 360 days were 88. 5% (46/52) and 82. 3% (43/52). While those of group L were 42. 3% (22/52) ,76.9% (40/52),86.5%(45/52), 75.0% (39/52) and group M + L were 55. 8 % (29/52), 88.5 % (46/52), 94. 2% (49/52),86. 5％ (45/52). Significant difference of survival rates and total effective between group M + L and M,M + L and L was found(χ2 = 6. 27,6. 16, P ＜ 0. 05). At the same time adverse responses of incidence and persis time such as febricity, nausea and vomit, hepatic pain were more lower in group M + L and group M.Three groups febricity rate were 63.4% (33/52), 86. 5% (45/52) and 69. 2% (36/52), nausea and vomit were 67.3 % (35/52) ,84. 6% (44/52) and 76. 9% (40/52), hepatic pain were 59. 6% (31/52), 86. 5 %(45/52), 73. 1% (38/52) (χ2 = 6.55, 6. 22, 6. 90, P ＜ 0. 05). Conclusion Embolization with microspheres can get longer and more effective treatment. TACE with microspheres and lipiodol for embolizing HCC was more effective than with Microspheres or lipiodol alone.
