Short and Long Term Effects of Transcatheter Arterial Chemoembolization Combined with Portal Vein 125 Iodine Seed Implantation in the Treatment of Liver Cancer Complicated with Portal Vein Tumor Thrombus
ZHAO Yong-hua, BAI Xue-mei, LIU Ya-min, et al
Department of interventional vascular, Chang'an District Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710100, Shaanxi
摘要【目的】探讨经肝动脉化疗栓塞(TACE)联合门静脉碘125(125I)粒子植入治疗肝癌合并门静脉癌栓(PVTT)的近远期效果及安全性。【方法】在本院接受治疗的90例肝癌合并PVTT的患者随机分为对照组和观察组,对照组采用TACE治疗,观察组采用TACE联合门静脉125I粒子植入治疗。比较两组治疗前后血清学指标,治疗后复发率、生存率、无进展生存时间(PFS)、总生存期(OS)。比较两组肝脏原发肿瘤、PVTT的近期疗效以及治疗期间不良反应发生率。【结果】(1)观察组的原发肿瘤缓解率、PVTT 缓解率均高于对照组,且差异均有显著性(P均<0.05)。(2)治疗后观察组患者的血清甲胎蛋白(AFP)、癌胚抗原(CEA)测定值均低于对照组,血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)水平均高于对照组(P均<0.05)。(3)观察组1年的复发率低于对照组(22.2% vs 28.9%,P<0.05),1、2、3年累积生存率均高于对照组[分别为73.3% vs 57.8%、44.4% vs 24.4%、33.3% vs 15.6%,(P均<0.05)]。观察组平均PFS,平均OS均长于对照组(P均<0.05)。(4)治疗期间两组不良反应发生率相比较差异无显著性(P>0.05)。【结论】TACE联合门静脉125I粒子植入治疗肝癌合并PVTT的疗效确切,可有效控制原发肿瘤和PVTT进展,延长患者生存时间,提高生存率,且安全性较好。
Abstract：【Objective】To investigate the short-term and long-term effect and safety of transcatheter arterial chemoembolization (TACE) combined with portal vein 125 iodine (125I) seed implantation in the treatment of liver cancer complicated with portal vein tumor thrombus (PVTT). 【Methods】 A total of 90 patients with liver cancer complicated with PVTT was randomly divided into control group and observation group. The control group was treated with TACE, and the observation group was treated with TACE combined with portal vein 125I seed implantation. The serological indexes, recurrence rate, survival rate, progression free survival time (PFS) and overall survival time (OS) were compared between the two groups before and after treatment. The short-term efficacy of primary liver tumor and PVTT and the incidence of adverse reactions during treatment were compared between the two groups. 【Results】(1) the remission rate of primary tumor and PVTT in the observation group were significantly higher than those in the control group (P<0.05). (2) After treatment, the serum levels of alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA) in the observation group were lower than those in the control group, and the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in the observation group were higher than those in the control group (P<0.05). (3) The 1-year recurrence rate in the observation group was lower than that in the control group (22.2% vs 28.9%, P<0.05), and the 1, 2 and 3-year cumulative survival rates were higher than those in the control group (73.3% vs 57.8%, 44.4% vs 24.4%, 33.3% vs 15.6%, respectively) (P<0.05). The average PFS and OS in the observation group were longer than those in the control group (all P<0.05). (4) There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). 【Conclusion 】 TACE combined with 125I seed implantation in portal vein is effective in the treatment of liver cancer complicated with PVTT. It can effectively control the progression of primary tumor and PVTT, prolong the survival time and improve the survival rate, and has good safety.
赵永华, 白雪梅, 刘亚民, 赵新汉, 张娜. 经肝动脉化疗栓塞联合门静脉碘125粒子植入治疗肝癌合并门静脉癌栓的近远期效果[J]. 医学临床研究, 2021, 38(9): 1378-1381.
ZHAO Yong-hua, BAI Xue-mei, LIU Ya-min, et al. Short and Long Term Effects of Transcatheter Arterial Chemoembolization Combined with Portal Vein 125 Iodine Seed Implantation in the Treatment of Liver Cancer Complicated with Portal Vein Tumor Thrombus. JOURNAL OF CLINICAL RESEARCH, 2021, 38(9): 1378-1381.
2021, Vol. 38 
