CAJ | 학술논문

目的评价经肝动脉介入治疗(TAIT)在肝转移癌综合治疗中的价值,探讨影响患者预后的因素.方法回顾性分析中国医学科学院肿瘤医院1997年1月至2000年6月收治的470例肝转移癌患者共行TAIT 1231例次的临床资料,观察其近期、远期疗效和毒副作用,评价TAIT对肝转移癌患者的疗效,采用Cox回归模型分析可能影响患者预后的因素.结果 470例患者中有94例完全缓解,143例部分缓解,总有效率为50.4%(237/470),中位生存时间为13.5个月,0.5、1、2、3、5年生存率分别为86.4%、66.8%、35.6%、16.9%、7.3%,全组无严重并发症发生.原发肿瘤是否切除、肿瘤血供状况、肝转移癌是单发还是多发、有无门静脉栓塞、TAIT后是否行辅助化疗、原发肿瘤是否为乳腺癌、肿瘤是否累及多个肝叶、TAIT前是否伴有其他部位转移是影响患者预后的8项因素(X2=17.322,12.593,8.721,8.573,8.492,7.838,5.623,5.463,P<0.05).结论 TAIT对不能手术的肝转移癌是一种有效姑息性治疗方法.原发肿瘤已切除、肿瘤血供丰富、孤立性肝转移癌、肿瘤仅累及单个肝叶、无门静脉栓塞、原发肿瘤为乳腺癌、TAIT后行辅助化疗、无其他部位转移的患者,TAIT疗效较好.
목적 평개경간동맥개입치료(TAIT)재간전이암종합치료중적개치,탐토영향환자예후적인소.방법 회고성분석중국의학과학원종류의원1997년1월지2000년6월수치적470례간전이암환자공행TAIT 1231례차적림상자료,관찰기근기、원기료효화독부작용,평개TAIT대간전이암환자적료효,채용Cox회귀모형분석가능영향환자예후적인소.결과 470례환자중유94례완전완해,143례부분완해,총유효솔위50.4%(237/470),중위생존시간위13.5개월,0.5、1、2、3、5년생존솔분별위86.4%、66.8%、35.6%、16.9%、7.3%,전조무엄중병발증발생.원발종류시부절제、종류혈공상황、간전이암시단발환시다발、유무문정맥전새、TAIT후시부행보조화료、원발종류시부위유선암、종류시부루급다개간협、TAIT전시부반유기타부위전이시영향환자예후적8항인소(X2=17.322,12.593,8.721,8.573,8.492,7.838,5.623,5.463,P<0.05).결론 TAIT대불능수술적간전이암시일충유효고식성치료방법.원발종류이절제、종류혈공봉부、고립성간전이암、종류부루급단개간협、무문정맥전새、원발종류위유선암、TAIT후행보조화료、무기타부위전이적환자,TAIT료효교호.
Objective To evaluate the efficacy of transarterial interventional therapy (TAIT) in treating patients with metastatic liver cancer, and to investigate the factors influencing the prognosis of patients. Methods From January 1997 to June 2000, 470 patients with metastatic liver cancer had undergone TAIT 1231 times in the Cancer Hospital of the Chinese Academy of Medical Sciences. The clinical data of the patients were retrospectively analyzed. The short-term and long-term efficacy and the side effect of TAIT were assessed. The potential factors influencing the prognosis of the patients were determined by Cox regression analysis. Results Complete remission was observed in 94 patients, and partial remission in 143. The total effective rate was 50.4% (237/470). The median survival time was 13.5 months. The O. 5-, 1-, 2-, 3-, 5-year survival rates were 86.4%, 66. 8%, 35.6%, 16.9%, 7.3%, respectively. No severe complication occurred. The factors influencing the prognosis of the patients were: the resection of the primary tumor, blood supply of the tumor, multiple metastases of liver cancer, thrombus in the portal vein, adjuvant chemotherapy after TAIT, tumor originated from breast cancer, tumors invading multiple lobes, concurrent metastasis in other sites (X2= 17. 322, 12. 593, 8.721, 8.573, 8.492, 7. 838, 5. 623, 5. 463, P < 0.05). Conclusions TAIT is an effective palliative therapy for metastatic liver cancer which cannot be resected. The factors mentioned above influence the prognosis of patients after TAIT.