摘要: |
目的:探讨微波消融(microwave ablation, MWA)联合经肝动脉插管化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗肝细胞肝癌(hepatocellular carcinoma,HCC)伴门静脉癌栓(portal vein tumor thrombus,PVTT)的安全性和有效性。方法:2014年1月至2015年12月共纳入145例HCC合并程氏门静脉癌栓分型Ⅰ型(二级分支或肝段支)PVTT的患者。治疗组75例患者接受MWA和TACE联合治疗;对照组70例患者仅接受TACE术。主要终点指标为总体生存时间(overall survival,OS),次要终点指标为治疗反应率(response rate,RR)、肿瘤进展时间(time to progression,TTP)和不良事件(adverse event,AE)。结果:联合治疗组患者术后1年、2年生存率分别为74.7%、51.7%,中位生存时间为25.0个月(95%CI 19.6~30.4)。对照组患者术后1年、2年生存率分别为62.9%、29.1%,中位生存时间为16.0个月(95%CI 11.3~20.7)。联合治疗组中位生存时间长于对照组(P=0.011)。联合治疗组患者中位肿瘤进展时间长于对照组(22.7个月 vs12.4个月,P=0.006)。联合治疗组患者客观缓解率高于对照组(69.3 % vs 51.4 %,P=0.041)。结论:微波消融联合化疗栓塞治疗HCC伴门脉癌栓安全有效。 |
关键词: 肝细胞肝癌 门静脉癌栓 微波消融 化疗栓塞 |
DOI:10.12025/j.issn.1008-6358.2017.20170219 |
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Abstract: |
Objective:To explore the safety and efficacy of the combination therapy of microwave ablation (MWA) and transcatheter arterial chemoembolization (TACE) in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods:One hundred and forty five patients with HCC and Cheng’s classification Ⅰ (second order branch or segmental) PVTT were recruited. Seventy five patients were treated with the combination of MWA and TACE. Seventy patients were treated with chemoembolization only. The overall survival (OS), response rate (RR), time to progression (TTP) and adverse events (AE) were compared. Results:In the combination therapy group, the survival rates at 12 and 24 months were 74.7 % and 51.7 %, respectively, and the median overall survival was 25.0 months (95%CI 19.6-30.4). In the control group, the survival rates at 12 and 24 months were 62.9 % and 29.1 %, respectively, and the median OS was 16.0 months (95%CI 11.3-20.7).Survival was significantly longer in the combination therapy group than in the control group(P=0.011). The median TTP was 22.7 months in the combination therapy group, and 12.4 months in the control group (P=0.006).The objective response rate was significantly higher in combination therapy group when compared with TACE only therapy group (combination therapy: 69.3 %, TACE only: 51.4 %; P=0.041). Conclusions:The combination of MWA and TACE is a safe and effective treatment modality in treating HCC and PVTT. |
Key words: hepatocellular carcinoma portal vein tumor thrombosis microwave ablation chemoembolization |