CAJ | 학술논문

目的探讨对不能切除的小儿肝母细胞瘤实行动脉化疗栓塞术(TACE)治疗的临床可行性、疗效及作用.方法 8例常规不能切除的肝母细胞瘤经TACE治疗20次,再行Ⅱ期外科手术切除,比较分析治疗前后临床症状、体征和血AFP的变化、术中情况及随访远期疗效.结果 TACE术后4～6周复查,和术前相比.肿瘤体积缩小67.68%～95.91%,平均缩小87.91%(t=3.754,P=0.007),血AFP下降94.46%～99.97%,平均98.45%(t=2.931,P=0.022),无明显的化疗毒性反应,所有患儿手术完整切除肿瘤,术后病理显示肿瘤明显坏死.随访8～24个月,所有患儿均获无瘤生存.结论 TACE治疗肝母细胞瘤安全有效,无严重并发症,能使部分不能Ⅰ期手术的患儿重新获得手术机会,并对减少术中肿瘤细胞的扩散和术中出血、改善预后有较大作用,可作为无远处转移肝母细胞瘤的术前辅助治疗.
목적 탐토대불능절제적소인간모세포류실행동맥화료전새술(TACE)치료적림상가행성、료효급작용.방법 8례상규불능절제적간모세포류경TACE치료20차,재행Ⅱ기외과수술절제,비교분석치료전후림상증상、체정화혈AFP적변화、술중정황급수방원기료효.결과 TACE술후4～6주복사,화술전상비.종류체적축소67.68%～95.91%,평균축소87.91%(t=3.754,P=0.007),혈AFP하강94.46%～99.97%,평균98.45%(t=2.931,P=0.022),무명현적화료독성반응,소유환인수술완정절제종류,술후병리현시종류명현배사.수방8～24개월,소유환인균획무류생존.결론 TACE치료간모세포류안전유효,무엄중병발증,능사부분불능Ⅰ기수술적환인중신획득수술궤회,병대감소술중종류세포적확산화술중출혈、개선예후유교대작용,가작위무원처전이간모세포류적술전보조치료.
Objective To evaluate the feasibility.efficacy of transcatheter arterial chemoemboli-zation (TACE) for unresectable hepatoblastoma in children.Methods Eight patients with unresect-able hepatoblastoma underwent 20 TACE before the secondary surgical resections.The changes of elinical symptoms,signs and AFP before and after TACE were analyzed.The long term therapeutic effect was assessed,Results Re-examinations were perfclrmed in 4 to 6 weeks after TAC E.The tumors treated with TACE decreased in size bv 87.91%(67.68-95.91%)(Paired samples T-test,t=3.754,P=0.007),and the levels of AFP dropped bv 98.45%(94.46-99.97%)(Paired samples T-test,t=2.931,P=0.022).No significant chemotherapeutic toxicity was observed.All eight hepato-blastomas were safely excised after the chemotherapy.Pathological examination showed massive nec-rosis in the resected tumor tissues.During the 8-24 months follow-up period,tumor-free survival was observed in all eight patients.Conclusions TACE iS a safe,effective therapeutic method for unresect-able hepatoblastoma in children.It is also effective in reducing hemorrhage during operation.It is an effective adjuvant therapy for hepatoblastoma with no metastasis.