CAJ | 학술논문

目的评价巨大肝癌患者单纯应用经肝动脉化疗栓塞术(TACE)和综合治疗的临床疗效和预后.方法回顾性分析2008年8月至2012年1月,解放军总医院介入放射科收治的115例巨大肝癌患者,分为单纯TACE治疗组(TACE组)72例,TACE联合治疗组(综合治疗组)43例,分析其生存情况.结果 115例巨大肝癌患者中,TACE组患者的中位生存时间为11个月,1、2、3年生存率分别为60.4％、23.3％和9.8％.综合治疗组患者的中位生存时间为39个月,1、2、3年生存率分别为78.1％、43.3％和 36.8％,两组患者的生存曲线比较,差异有统计学意义(P＜0.001).单因素分析结果显示,巨大肝癌患者的性别、年龄、肝炎病毒感染情况、AFP水平均与患者的预后无关(均P＞0.05),而综合治疗、Child分级、ECOG评分、远处转移情况、J脉癌栓形成和BCLC分期均与患者的预后有关(均P＜0.05).Cox D归分析结果显示,综合治疗和ECOG评分是影响巨大肝癌患者预后的独立因素(均P ＜0.05).结论综合治疗巨大肝癌是一种安全有效的治疗策略.综合治疗及ECOG评分是影响HCC患者预后的因素.
목적 평개거대간암환자단순응용경간동맥화료전새술(TACE)화종합치료적림상료효화예후.방법 회고성분석2008년8월지2012년1월,해방군총의원개입방사과수치적115례거대간암환자,분위단순TACE치료조(TACE조)72례,TACE연합치료조(종합치료조)43례,분석기생존정황.결과 115례거대간암환자중,TACE조환자적중위생존시간위11개월,1、2、3년생존솔분별위60.4％、23.3％화9.8％.종합치료조환자적중위생존시간위39개월,1、2、3년생존솔분별위78.1％、43.3％ 화 36.8％,량조환자적생존곡선비교,차이유통계학의의(P＜0.001).단인소분석결과현시,거대간암환자적성별、년령、간염병독감염정황、AFP수평균여환자적예후무관(균P＞0.05),이종합치료、Child분급、ECOG평분、원처전이정황、J맥암전형성화BCLC분기균여환자적예후유관(균P＜0.05).Cox D귀분석결과현시,종합치료화ECOG평분시영향거대간암환자예후적독립인소(균P ＜0.05).결론 종합치료거 대간암시일충안전유효적치료책략.종합치료급ECOG평분시영향HCC환자예후적인소.
Objective The aim of this study was to evaluate the efficacy,survival and prognosis of transarterial chemoembolization (TACE) alone and TACE in combination with multimodality therapy for huge hepatocellular carcinoma.Methods A retrospective analysis was conducted in 115 patients with huge hepatocellular carcinoma treated in our hospital from August 2008 to January 2012.Among them,72 patients were treated by TACE alone (TACE group) and 43 patients by TACE plus multimodality therapy (TACE-combined treatment group).Their clinicopathological data and survival were analyzed.Results The median follow-up of the 115 cases was 24 months (range 1-40 months).The 1-,2-,and 3-year overall survival (OS) rates for the TACE group were 60.4,％ 23.3％ and 9.8％,respectively,and 39 months,78.1％,43.3％ and 36.8％,respectively,for the combined treatment group (P ＜0.001).The univariate analysis showed that the patient gender and age,HIV infection and AFP level were not significantly correlated with prognosis of the patients (P ＞ 0.05 for all),while multimodality therapy,Child's grading,ECOG scores,distant metastasis,and portal vein tumor thrombus were significantly related to the overall survival.Moreover,the Cox multivariate survival analysis revealed that therapy and ECOG scores were independent prognostic indicators (P ＜ 0.05 for all).Conclusions Multimodality therapy is a safe and effective treatment for huge hepatocellular carcinoma.Multimodality therapy and ECOG scores are independent prognostic indicators for the patients.